Treatment of functional dyspepsia |
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Authors: | Silvia Delgado-Aros Filippo Cremonini Nicholas J Talley |
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Institution: | (1) Clinical Enteric Neuroscience Translational & Epidemiological Research Program, Mayo Clinic, Charlton 8-138, 200 First Street SW, 55905 Rochester, MN, USA |
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Abstract: | Opinion statement Functional dyspepsia is a common chronic condition. It can have a major impact on quality of life and remains a large burden
on healthcare resources. Its underlying mechanisms are not fully understood and therapies are mainly empirical. In this review,
we summarize the best evidence on available therapeutic interventions in functional dyspepsia. Helicobacter pylori eradication, for those infected, is likely a safe and cost-effective strategy but benefits only a minority. Antisecretory
agents such as proton-pump inhibitors and histamine-2 receptor antagonists have shown some benefit and are recommended as
the firstline option in the absence of H. pylori infection. There is a lack of strong evidence of benefit from prokinetic agents, and cisapride, the most studied agent, is
largely unavailable. Antidepressants need to be adequately tested in functional dyspepsia, but both psychotherapy and hypnotherapy
interventions have shown promising results. Herbal therapies need further study in these patients. 5-Hydroxytryptamine3 (5-HT3) and 5-HT4 receptor antagonists, and cholecystokinin type A and neurokinin receptor antagonists remain promising emerging therapies. |
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