Journal of Gastroenterology

, Volume 41, Issue 11, pp 1025–1040 | Cite as

Recent insights into digestive motility in functional dyspepsia

  • Yohei Mizuta
  • Saburo Shikuwa
  • Hajime Isomoto
  • Ryosuke Mishima
  • Yuko Akazawa
  • Jun-ichi Masuda
  • Katsuhisa Omagari
  • Fuminao Takeshima
  • Shigeru Kohno


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.

Key words

accommodation digestive motility functional dyspepsia gastric emptying Helicobacter pylori visceral hypersensitivity 


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Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Yohei Mizuta
    • 1
  • Saburo Shikuwa
    • 1
  • Hajime Isomoto
    • 1
  • Ryosuke Mishima
    • 1
  • Yuko Akazawa
    • 1
  • Jun-ichi Masuda
    • 1
  • Katsuhisa Omagari
    • 1
  • Fuminao Takeshima
    • 2
  • Shigeru Kohno
    • 1
  1. 1.Second Department of Internal MedicineNagasaki University School of MedicineNagasakiJapan
  2. 2.Department of General MedicineNagasaki University School of MedicineNagasakiJapan

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