Dyspepsia: Treatment Options Directed to Specific Targets

AbstractPurpose of reviewFunctional dyspepsia (FD) is a highly prevalent condition affecting up to 12% of the US population. We reviewed the recent medical literature regarding therapeutic interventions and aimed to identify guidance for the most appropriate/effective treatment in patients presenting with FD.Recent findingsThere are a variety of therapeutic interventions that have recently demonstrated clinical efficacy in placebo-controlled trials and subsequent systematic reviews and meta-analysis. Pharmacologic interventions include acid inhibition, prokinetics, antimicrobial interventions, and central nervous system acting drugs (with emphasis on tricyclic antidepressant). In addition, available data support the use of specific herbal preparations. However, while treatments may substantially improve symptoms in individual patients, for all effective (pharmacologic and non-pharmacologic) interventions, the gain over placebo is only small consistent with the concept that FD actually is caused by a variety of underlying mechanisms and the occurrence of spontaneous fluctuation of disease activity that may amplify ‘placebo responses’.SummaryFD is a condition with a most likely multifaceted pathophysiology. Thus, it is unlikely that a single pharmacologic intervention will provide cure or even symptom relief for a large proportion of patients. While the symptom-based categorisation of FD (postprandial distress syndrome and epigastric pain syndrome) is intuitive, it remains ...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research