Pathophysiology and treatment of functional dyspepsia.

Dyspeptic symptoms, defined as discomfort or pain in the upper part of the abdomen, occur very commonly in the general population. Epidemiologic surveys suggest that 15%–20% of the general population in Western countries experience dyspepsia over the course of 1 year. Despite the fact that only about 1 in 4 people with dyspeptic symptoms choose to consult a physician, dyspepsia is a clinical problem of considerable magnitude for the health care system due to the high prevalence and the chronic or recurrent nature of symptoms. Most of these patients have no identifiable cause of dyspepsia by standard diagnostic tests, which is referred to as functional dyspepsia. According to international consensus, the definition of functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen without evidence of organic disease likely to explain the symptoms. Discomfort refers to unpleasant sensations that the subject does not interpret as pain and may be characterized by upper abdominal fullness, early satiety, bloating, belching, or nausea. Furthermore, there is no relation between dyspeptic symptoms and bowel movements (i.e., irritable bowel syndrome does not explain the symptoms), and patients with predominant heartburn should be excluded.