Recent insights into digestive motility in functional dyspepsia |
| |
Authors: | Yohei Mizuta Saburo Shikuwa Hajime Isomoto Ryosuke Mishima Yuko Akazawa Jun-ichi Masuda Katsuhisa Omagari Fuminao Takeshima Shigeru Kohno |
| |
Institution: | (1) Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;(2) Department of General Medicine, Nagasaki University School of Medicine, Nagasaki, Japan |
| |
Abstract: | Functional gastrointestinal disorders, such as functional dyspepsia (FD) and irritable bowel syndrome, are common pathologies
of the gut. FD is a clinical syndrome defined as chronic or recurrent pain or discomfort of unknown origin in the upper abdomen.
The pathophysiological mechanisms responsible for FD have not been fully elucidated, but new ideas regarding its pathophysiology
and the significance of the pathophysiology with respect to the symptom pattern of FD have emerged. In particular, there is
growing interest in alterations in gastric motility, such as accommodation to a meal or gastric emptying, and visceral sensation
in FD. The mechanisms underlying impaired gastroduodenal motor function are unclear, but possible factors include abnormal
neurohormonal function, autonomic dysfunction, visceral hypersensitivity to acid or mechanical distention, Helicobacter pylori infection, acute gastrointestinal infection, psychosocial comorbidity, and stress. Although the optimum treatment for FD
is not yet clearly established, acid-suppressive drugs, prokinetic agents, eradication of H. pylori, and antidepressants have been widely used in the management of patients with FD. The therapeutic efficacy of prokinetics
such as itopride hydrochloride and mosapride citrate in the treatment of FD is supported by the results of relatively large
and well-controlled studies. In addition, recent research has yielded new therapeutic agents and modalities for dysmotility
in FD, including agonists/antagonists of various sensorimotor receptors, activation of the nitrergic pathway, kampo medicine, acupuncture, and gastric electric stimulation. This review discusses recent research on the pathophysiology of
and treatment options for FD, with special attention given to digestive dysmotility. |
| |
Keywords: | accommodation digestive motility functional dyspepsia gastric emptying Helicobacter pylori visceral hypersensitivity |
本文献已被 PubMed SpringerLink 等数据库收录! |
|