Skip to main content

Functional (Nonulcer) Dyspepsia

  • Chapter
  • First Online:
Dyspepsia in Clinical Practice

Abstract

The term dyspepsia describes a heterogeneous group of symptoms originating from the epigastric region (stomach and duodenum). Dyspeptic symptoms include postprandial fullness, early satiation, epigastric pain, and epigastric burning (Table 5.1). Structural causes responsible for dyspeptic symptoms are discussed in Chap. 4. According to the Rome III consensus conference (2006), functional dyspepsia (FD) is defined as the presence of dyspeptic symptoms thought to generate in the gastroduodenal region, in the absence of organic, systemic, or metabolic disease that is likely to explain the symptoms [1]. Symptoms originating from the esophagus such as heartburn or regurgitation are not included in the current definition. For diagnosis of FD, the presence of one or more dyspeptic symptoms for the last 3 months with symptoms onset at least 6 months before diagnosis is required. Particularly for pathophysiological and therapeutic research purposes, the Rome III consensus conference defined two subentities of FD:

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–79.

    Article  PubMed  Google Scholar 

  2. El-Serag HB, Talley NJ. Systemic review: the prevalence and clinical course of functional dyspepsia. Aliment Pharmacol Ther. 2004;19:643–54.

    Article  PubMed  CAS  Google Scholar 

  3. Zagari RM, Law GR, Fuccio L, et al. Epidemiology of functional dyspepsia and subgroups in the Italian general population: an endoscopic study. Gastroenterology. 2010;138:1302–11.

    Article  PubMed  Google Scholar 

  4. Agréus L, Svärdsudd K, Nyrén O, Tibblin G. Irritable bowel syndrome and dyspepsia in the general population: overlap and lack of stability over time. Gastroenterology. 1995;109:671–80.

    Article  PubMed  Google Scholar 

  5. McQuaid KR. Dyspepsia. In: Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger & Fordtran’s gastrointestinal and liver disease. 8th ed. Philadelphia: Saunders Elsevier; 2009. p. 121–42.

    Google Scholar 

  6. Talley N, Dennis EH, Schettler-Duncan VA, Olden LBE, KW CMD. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003;98:2454–9.

    Article  PubMed  Google Scholar 

  7. Corsetti M, Caenepeel P, Fischler B, Janssens J, Tack J. Impact of coexisting irritable bowel syndrome on symptoms and pathophysiological mechanisms in functional dyspepsia. Am J Gastroenterol. 2004;99:1152–9.

    Article  PubMed  Google Scholar 

  8. Stanghellini V, Tosetti C, Barbara G, et al. Dyspeptic symptoms and gastric emptying in the irritable bowel syndrome. Am J Gastroenterol. 2002;97:2738–43.

    Article  PubMed  Google Scholar 

  9. Koloski NA, Talley NJ, Huskic SS, Boyce PM. Predictors of conventional and alternative health care seeking for irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther. 2003;17:841–51.

    Article  PubMed  CAS  Google Scholar 

  10. Quadri A, Vakil N. Health-related anxiety and the effect of open-access endoscopy in US patients with dyspepsia. Aliment Pharmacol Ther. 2003;17:835–40.

    Article  PubMed  CAS  Google Scholar 

  11. Koloski NA, Talley NJ, Boyce PM. Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia: a critical review of the literature on symptom and psychosocial factors. Am J Gastroenterol. 2001;96:1340–9.

    Article  PubMed  CAS  Google Scholar 

  12. Talley NJ, Choung RS. Whither dyspepsia? A historical perspective of functional dyspepsia, and concepts of pathogenesis and therapy in 2009. J Gastroenterol Hepatol. 2009;24 Suppl 3:S20–8.

    Article  PubMed  Google Scholar 

  13. Gathaiya N, Locke 3rd GR, Camilleri M, Schleck CD, Zinsmeister AR, Talley NJ. Novel associations with dyspepsia: a community-based study of familial aggregation, sleep dysfunction and somatization. Neurogastroenterol Motil. 2009;21:922–e69.

    Article  PubMed  CAS  Google Scholar 

  14. Holtmann G, Siffert W, Haag S, et al. G-protein beta 3 subunit 825 CC genotype is associated with unexplained (functional) dyspepsia. Gastroenterology. 2004;126:971–9.

    Article  PubMed  CAS  Google Scholar 

  15. Camilleri CE, Carlson PJ, Camilleri M, et al. A study of candidate genotypes associated with dyspepsia in a U.S. community. Am J Gastroenterol. 2006;101:581–92.

    Article  PubMed  CAS  Google Scholar 

  16. Kindt S, Tack J. Impaired gastric accommodation and its role in dyspepsia. Gut. 2006;55:1685–91.

    Article  PubMed  CAS  Google Scholar 

  17. Azpiroz F, Malagelada JR. Gastric tone measured by an electronic barostat in health and postsurgical gastroparesis. Gastroenterology. 1987;92:934–43.

    PubMed  CAS  Google Scholar 

  18. Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J. Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology. 1998;115:1346–52.

    Article  PubMed  CAS  Google Scholar 

  19. Troncon LE, Bennett RJ, Ahluwalia NK, Thompson DG. Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients. Gut. 1994;35:327–32.

    Article  PubMed  CAS  Google Scholar 

  20. Kim DY, Delgado-Aros S, Camilleri M, et al. Noninvasive measurement of gastric accommodation in patients with idiopathic nonulcer dyspepsia. Am J Gastroenterol. 2001;96:3099–105.

    Article  PubMed  CAS  Google Scholar 

  21. Mearin F, Cucala M, Azpiroz F, Malagelada JR. The origin of symptoms on the brain-gut axis in functional dyspepsia. Gastroenterology. 1991;101:999–1006.

    PubMed  CAS  Google Scholar 

  22. Sarnelli G, Vos R, Cuomo R, Janssens J, Tack J. Reproducibility of gastric barostat studies in healthy controls and in dyspeptic patients. Am J Gastroenterol. 2001;96:1047–53.

    Article  PubMed  CAS  Google Scholar 

  23. Perri F, Clemente R, Festa V, et al. Patterns of symptoms in functional dyspepsia: role of Helicobacter pylori infection and delayed gastric emptying. Am J Gastroenterol. 1998;93:2082–8.

    Article  PubMed  CAS  Google Scholar 

  24. Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology. 2004;127:1239–55.

    Article  PubMed  Google Scholar 

  25. Feinle-Bisset C, Vozzo R, Horowitz M, Talley NJ. Diet, food intake, and disturbed physiology in the pathogenesis of symptoms in functional dyspepsia. Am J Gastroenterol. 2004;99:170–81.

    Article  PubMed  Google Scholar 

  26. Timmons S, Liston R, Moriarty KJ. Functional dyspepsia: motor abnormalities, sensory dysfunction, and therapeutic options. Am J Gastroenterol. 2004;99:739–49.

    Article  PubMed  Google Scholar 

  27. Mertz H. Review article: visceral hypersensitivity. Aliment Pharmacol Ther. 2003;17:623–33.

    Article  PubMed  CAS  Google Scholar 

  28. Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001;121:526–35.

    Article  PubMed  CAS  Google Scholar 

  29. Camilleri M, Coulie B, Tack J. Visceral hypersensitivity: facts, speculations, and challenges. Gut. 2001;48:125–31.

    Article  PubMed  CAS  Google Scholar 

  30. Mearin F, Pérez-Oliveras M, Perelló A, et al. Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study. Gastroenterology. 2005;129:98–104.

    Article  PubMed  Google Scholar 

  31. Tack J, Demedts I, Dehondt G, et al. Clinical and pathophysiological characteristics of acute-onset functional dyspepsia. Gastroenterology. 2002;122:1738–47.

    Article  PubMed  Google Scholar 

  32. Saslow SB, Thumshirn M, Camilleri M, et al. Influence of H. pylori infection on gastric motor and sensory function in asymptomatic volunteers. Dig Dis Sci. 1998;43:258–64.

    Article  PubMed  CAS  Google Scholar 

  33. Tucci A, Corinaldesi R, Stanghellini V, et al. Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia. Gastroenterology. 1992;103:768–74.

    PubMed  CAS  Google Scholar 

  34. Thumshirn M, Camilleri M, Saslow SB, Williams DE, Burton DD, Hanson RB. Gastric accommodation in non-ulcer dyspepsia and the roles of Helicobacter pylori infection and vagal function. Gut. 1999;44:55–64.

    Article  PubMed  CAS  Google Scholar 

  35. Rhee PL, Kim YH, Son HJ, et al. Lack of association of Helicobacter pylori infection with gastric hypersensitivity or delayed gastric emptying in functional dyspepsia. Am J Gastroenterol. 1999;94:3165–9.

    Article  PubMed  CAS  Google Scholar 

  36. Sarnelli G, Cuomo R, Janssens J, Tack J. Symptom patterns and pathophysiological mechanisms in dyspeptic patients with and without Helicobacter pylori. Dig Dis Sci. 2003;48:2229–36.

    Article  PubMed  Google Scholar 

  37. Moayyedi P, Deeks J, Talley NJ, Delaney B, Forman D. An update of the Cochrane systematic review of Helicobacter pylori therapy for nonulcer dyspepsia: resolving the discrepancy between systematic reviews. Am J Gastroenterol. 2003;98:2621–6.

    Article  PubMed  Google Scholar 

  38. Powell N, Huntley B, Beech T, Knight W, Knight H, Corrigan CJ. Increased prevalence of gastrointestinal symptoms in patients with allergic disease. Postgrad Med J. 2007;83:182–6.

    Article  PubMed  Google Scholar 

  39. Liu S, Hu HZ, Gao N, et al. Neuroimmune interactions in guinea pig stomach and small intestine. Am J Physiol Gastrointest Liver Physiol. 2003;284:G154–64.

    PubMed  CAS  Google Scholar 

  40. Reed DE, Barajas-Lopez C, Cottrell G, et al. Mast cell tryptase and proteinase-activated receptor 2 induce hyperexcitability of guinea-pig submucosal neurons. J Physiol. 2003;547:531–42.

    Article  PubMed  CAS  Google Scholar 

  41. Friesen CA, Sandridge L, Andre L, Roberts CC, Abdel-Rahman SM. Mucosal eosinophilia and response to H1/H2 antagonist and cromolyn therapy in pediatric dyspepsia. Clin Pediatr (Phila). 2006;45:143–7.

    Article  Google Scholar 

  42. Friesen CA, Kearns GL, Andre L, Neustrom M, Roberts CC, Abdel-Rahman SM. Clinical efficacy and pharmacokinetics of montelukast in dyspeptic children with duodenal eosinophilia. J Pediatr Gastroenterol Nutr. 2004;38:343–51.

    Article  PubMed  Google Scholar 

  43. Talley NJ, Walker MM, Aro P, et al. Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case–control study. Clin Gastroenterol Hepatol. 2007;5:1175–83.

    Article  PubMed  Google Scholar 

  44. Walker MM, Salehian SS, Murray CE, et al. Implications of eosinophilia in the normal duodenal biopsy – an association with allergy and functional dyspepsia. Aliment Pharmacol Ther. [published online ahead of print March 4, 2010].

    Google Scholar 

  45. Drossman DA, Creed FH, Olden KW, Svedlund J, Toner BB, Whitehead WE. Psychosocial aspects of the functional gastrointestinal disorders. Gut. 1999;45 Suppl 2:II25–30.

    Article  PubMed  Google Scholar 

  46. Talley NJ, Phillips SF, Bruce B, Twomey CK, Zinsmeister AR, Melton LJ. Relation among personality and symptoms in non-ulcer dyspepsia and the irritable bowel syndrome. Gastroenterology. 1990;99:327–33.

    PubMed  CAS  Google Scholar 

  47. Tanum L, Malt UF. Personality and physical symptoms in nonpsychiatric patients with functional gastrointestinal disorder. J Psychosom Res. 2001;50:139–46.

    Article  PubMed  CAS  Google Scholar 

  48. Locke 3rd GR, Weaver AL, Melton 3rd LJ, Talley NJ. Psychosocial factors are linked to functional gastrointestinal disorders: a population based nested case–control study. Am J Gastroenterol. 2004;99:350–7.

    Article  PubMed  Google Scholar 

  49. Mayer EA, Gebhart GF. Basic and clinical aspects of visceral hyperalgesia. Gastroenterology. 1994;107:271–93.

    PubMed  CAS  Google Scholar 

  50. Soo S, Moayyedi P, Deeks J, Delaney B, Lewis M, Forman D. Psychological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2005:CD002301.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marino Venerito .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media LLC

About this chapter

Cite this chapter

Venerito, M., Kandulski, A., Malfertheiner, P. (2011). Functional (Nonulcer) Dyspepsia. In: Duvnjak, M. (eds) Dyspepsia in Clinical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1730-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-1730-0_5

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1729-4

  • Online ISBN: 978-1-4419-1730-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics