Functional Dyspepsia

Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders, affecting over 20% of the population. The condition has 3 subtypes—epigastric pain syndrome, postprandial distress syndrome (PDS), and a combination of both—each thought to result from different mechanisms. Diagnosis is based on the Rome IV criteria, which define functional dyspepsia as the presence of one or more symptoms, such as epigastric pain, burning, early satiety, and postprandial fullness, and in the absence of structural disease detectable by imaging or endoscopy. These symptoms may be severe enough to interfere with daily activities. While some patients may also experience nausea, vomiting, or heartburn, these symptoms are typically infrequent. Patients should be tested and treated for if applicable. Further treatment involves symptom management with proton pump inhibitors (PPIs), H2-receptor antagonists (H2RAs), prokinetic agents, and antidepressants. Alarming symptoms such as weight loss, dysphagia, or vomiting warrant an endoscopic evaluation.