Department of Medical Sciences, University of Turin, Turin, Italy.
Unit of Gastroenterology, Biella Hospital, Ponderano, Biella, Italy.
Minerva Gastroenterol Dietol. 2020 Dec;66(4):331-342. doi: 10.23736/S1121-421X.20.02732-4. Epub 2020 Jul 3.
Dyspepsia is a disorder that refers mainly to central upper abdominal pain or discomfort. When a cause of this symptom is not identified the condition is termed functional dyspepsia (FD), that affects a large part of the general population. The relevance of FD is due to its high prevalence, but also to its chronic or intermittent course. This induces a significant burden for each national healthcare system. The pathogenesis of FD is complex and multifactorial, depending on cultural, environmental, and biological factors. Although considered of main importance in the pathophysiology of several gastroduodenal diseases, in the context of FD Helicobacter pylori (H. pylori) infection plays a limited role. The diagnosis of FD requires the exclusion of organic gastroduodenal diseases as well as H. pylori infection. Thus, the diagnostic workup includes a complete anamnesis, biochemical tests, and endoscopy with biopsy (when requested), and the satisfaction of clinic criteria recommended by the Rome IV consensus. The treatment of FD is also challenging, in fact more and more studies focused on a wide range of different therapies, with a multitude of results. The aim of this literature review is to provide an update of the new evidences useful for diagnosis and management of FD.
消化不良主要是指中上腹部疼痛或不适的一种疾病。当无法确定该症状的原因时，这种情况被称为功能性消化不良（FD），它影响了很大一部分普通人群。FD 的相关性在于其高发病率，也在于其慢性或间歇性病程。这给每个国家的医疗保健系统都带来了巨大的负担。FD 的发病机制复杂且多因素，取决于文化、环境和生物学因素。尽管在几种胃十二指肠疾病的病理生理学中被认为是主要因素，但在 FD 中，幽门螺杆菌（H. pylori）感染的作用有限。FD 的诊断需要排除器质性胃十二指肠疾病以及 H. pylori 感染。因此，诊断工作包括完整的病史、生化检查和内镜活检（如有要求），并满足罗马 IV 共识推荐的临床标准。FD 的治疗也具有挑战性，事实上，越来越多的研究集中在广泛的不同治疗方法上，结果也多种多样。本文旨在提供对 FD 的诊断和管理有用的新证据的最新更新。
