Indiana University School of Medicine-Pediatric Gastroenterology, 705 Riley Hospital Drive ROC 4210, Indianapolis, IN, 46202, USA.
Alabama College of Osteopathic Medicine, 220 Magnolia Ridge Place #306, Dothan, AL, 36303, USA.
Clin J Gastroenterol. 2022 Feb;15(1):30-40. doi: 10.1007/s12328-021-01561-w. Epub 2021 Dec 2.
Functional gastrointestinal disorders have been known as a diagnosis of exclusion since the Rome Foundation first created these criteria in 1990. Since that time, a large amount of research and clinical data has better clarified the mechanisms and treatment options for these. Functional dyspepsia is caused by physiologic, genetic, environmental, and psychological factors, as well as various functional abnormalities, such as increased sensitivity to acid, increased sensitivity to duodenal lipids and low-grade inflammation. This disorder has significant symptom overlap between other functional disorders, such as irritable bowel syndrome and gastroparesis, but has differential criteria and two new subclasses: postprandial distress syndrome and epigastric pain syndrome. Diagnosis of functional dyspepsia should be based upon appropriate clinical evaluation in tandem with Rome IV criteria. In recent years, many treatment measures for functional dyspepsia have been studied, such as pharmacologic intervention, behavioral therapy, or alternative therapy, an example being hypnotherapy. These treatment measures have proven to be effective in symptom reduction in pediatrics. Though this disorder is functional, it has been shown to cause a significant impact on pediatric patients' quality of life continuing into adulthood.
功能性胃肠病自 1990 年罗马基金会首次制定这些标准以来，一直被认为是一种排除性诊断。从那时起，大量的研究和临床数据已经更好地阐明了这些疾病的发病机制和治疗选择。功能性消化不良是由生理、遗传、环境和心理因素以及各种功能异常引起的，如胃酸敏感性增加、十二指肠脂质敏感性增加和低度炎症。这种疾病与其他功能性疾病（如肠易激综合征和胃轻瘫）之间存在显著的症状重叠，但具有不同的标准和两个新的亚类：餐后不适综合征和上腹痛综合征。功能性消化不良的诊断应基于适当的临床评估，并结合罗马 IV 标准。近年来，许多功能性消化不良的治疗措施已经被研究，如药物干预、行为疗法或替代疗法，例如催眠疗法。这些治疗措施已被证明在儿科症状缓解方面有效。尽管这种疾病是功能性的，但它已被证明对儿科患者的生活质量产生重大影响，并持续到成年。
