Translational Research Centre for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Expert Opin Pharmacother. 2020 Feb;21(3):365-376. doi: 10.1080/14656566.2019.1707805. Epub 2020 Jan 3.
: 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.: This review summarizes the existing and off-label therapeutic options for FD.: 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.
功能性消化不良（FD）定义为源于胃十二指肠区域的慢性症状，而无明显可识别的器质性疾病，是最常见的胃肠道疾病之一。FD 分为两个亚组：餐后不适综合征（PDS）或与进餐相关的 FD，其特征为餐后饱胀和早饱；上腹疼痛综合征（EPS）或与进餐不相关的 FD，其特征为上腹疼痛和烧灼感。本文综述了 FD 的现有和标签外治疗选择。对发病机制的认识、罗马 IV 分类、减少 PDS/EPS 重叠以及症状识别的象形图有助于更好地诊断和更有针对性地选择治疗方案。乙酰甲胆碱是一种仅在日本和印度上市的新型促动力药物，是唯一被证实对 FD 有效的药物，但临床医生仍使用抑酸治疗、促动力药物、神经调节剂和草药治疗来缓解 FD 症状。新出现的靶点是十二指肠低度炎症伴嗜酸性粒细胞和十二指肠或其他改良腔微生物群。
