REVIEW   

Minerva Gastroenterologica e Dietologica 2020 December;66(4):331-42

DOI: 10.23736/S1121-421X.20.02732-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Management of functional dyspepsia in 2020: a clinical point of view

Elena MOSSO ¹, Silvia BONETTO ¹, Gianluigi LONGOBARDI ², Ludovico ABENAVOLI ³, Davide G. RIBALDONE ¹, Giorgio M. SARACCO ^{1, 4}, Rinaldo PELLICANO ⁴ ✉

¹ Department of Medical Sciences, University of Turin, Turin, Italy; ² Unit of Gastroenterology, Biella Hospital, Ponderano, Biella, Italy; ³ Department of Health Sciences, Magna Graecia University, Catanzaro, Italy; ⁴ Unit of Gastroenterology, Molinette Hospital, Turin, Italy

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.

KEY WORDS: Dyspepsia; Helicobacter pylori; Pain; Proton pump inhibitors