[Functional dyspepsia].

Abstract

The term "functional dyspepsia" describes a complex of symptoms which are related to the upper gastrointestinal tract and frequently experienced by the patients after food intake. The pathophysiology of functional dyspepsia is still poorly understood. There are no organic causes found nor are there any functional changes observed that correlate with symptom occurrence and intensity and which could offer a satisfactory explanation for the symptoms and a basis for successful therapy. Mechanisms discussed include a disturbance of gastric motility and emptying, an increased sensitivity of the stomach to or hypersecretion of gastric acid, and infection by Helicobacter pylori. Recent research indicates visceral hypersensitivity of the gastroduodenal region to mechanical (distension) and chemical (nutrients or neuromodulators) stimulation to be a major factor in the aetiology of functional dyspepsia, potentially offering an explanation why dyspeptic symptoms are often related to food intake. The occurrence of dyspeptic symptoms in relation to food ingestion frequently prompts the gastroenterologist to the diagnosis of a motility disorder and subsequent therapy with prokinetic drugs. These substances may result in an improvement of gastric emptying, but not necessarily symptoms. It is apparent that the incompletely understood pathophysiology of functional dyspepsia is one of the main reasons for the lack of an effective therapy for this common condition.