Current and emerging therapeutic options for the management of functional dyspepsia. (11th February 2020)

• Record Type: Journal Article
• Authors: Vandenberghe, A.; Schol, J.; Van den Houte, K.; Masuy, I.; Carbone, F.; Tack, J.
• Is Part Of: Expert opinion on pharmacotherapy. Volume 21:Number 3(2020)
• Page Start: 365
• Page End: 376
• Publication Date: 2020-02-11
• Subjects: Functional dyspepsia -- post prandial distress syndrome -- epigastric pain syndrome -- functional dyspepsia overlap -- therapeutic gap -- prokinetics -- proton pomp inhibitors -- potassium-competitive acid blockers -- medicinal herbal preparations -- neuromodulators -- duodenal microbiota -- probiotics -- duodenal inflammation -- anti-inflammatory approach -- postprandial distress syndrome -- overlap -- acid suppressants -- histamine receptor blockers -- herbal medicines; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2019.1707805
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction : Functional Dyspepsia (FD), defined as chronic symptoms originating from the gastroduodenal region in absence of readily identifiable organic disease, is one of the most common gastrointestinal disorders. FD is divided into two subgroups: Post-Prandial Distress Syndrome (PDS) or meal-related FD, characterized by postprandial fullness and early satiation, and Epigastric Pain Syndrome (EPS) or meal-unrelated FD, characterized by epigastric pain and burning. Areas covered : This review summarizes the existing and off-label therapeutic options for FD. Expert opinion : The identification of mechanisms, the Rome IV classification, the reduction of PDS/EPS overlap and pictograms for symptom identification allow a better diagnosis and a more targeted treatment choice. Acotiamide, a first-in-class prokinetic agent available only in Japan and India, is the only agent of proven efficacy for FD, but clinicians use acid-suppressive therapy, prokinetics, neuromodulators and herbal therapies for treating FD symptoms. New emerging targets are duodenal low-grade inflammation with eosinophils and duodenal or other modified luminal microbiota.