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class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Gastrointestinal disorder</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Functional dyspepsia</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Non-ulcer dyspepsia</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Symptoms-stomach-pain.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Symptoms-stomach-pain.jpg/220px-Symptoms-stomach-pain.jpg" decoding="async" width="220" height="285" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Symptoms-stomach-pain.jpg/330px-Symptoms-stomach-pain.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8f/Symptoms-stomach-pain.jpg/440px-Symptoms-stomach-pain.jpg 2x" data-file-width="2550" data-file-height="3300" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Abdominal_pain" title="Abdominal pain">Stomach pain</a> is a common symptom of functional dyspepsia.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Early satiety, <a href="/wiki/Heartburn" title="Heartburn">heartburn</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, postprandial fullness, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, and/or epigastric pain.<sup id="cite_ref-uptodate.com_a625_1-0" class="reference"><a href="#cite_note-uptodate.com_a625-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data">Symptoms of <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>, <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, and <a href="/wiki/Somatization" title="Somatization">somatization</a>.<sup id="cite_ref-Francis_Zavala_2023_r880_2-0" class="reference"><a href="#cite_note-Francis_Zavala_2023_r880-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data">Postprandial distress syndrome and epigastric pain syndrome.<sup id="cite_ref-uptodate.com_a625_1-1" class="reference"><a href="#cite_note-uptodate.com_a625-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Rome_process" title="Rome process">Rome IV</a> criteria.<sup id="cite_ref-uptodate.com_a625_1-2" class="reference"><a href="#cite_note-uptodate.com_a625-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a>, <a href="/wiki/Gastroparesis" title="Gastroparesis">gastroparesis</a>, and <a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">irritable bowel syndrome</a>.<sup id="cite_ref-uptodate.com_a625_1-3" class="reference"><a href="#cite_note-uptodate.com_a625-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Symptom control.<sup id="cite_ref-Francis_Zavala_2023_r880_2-1" class="reference"><a href="#cite_note-Francis_Zavala_2023_r880-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data"><a href="/wiki/Proton-pump_inhibitor" title="Proton-pump inhibitor">Proton pump inhibitors</a>, <a href="/wiki/H2_receptor_antagonist" title="H2 receptor antagonist">H2 receptor antagonists</a>, <a href="/wiki/Antidepressant" title="Antidepressant">antidepressants</a>, and <a href="/wiki/Prokinetic_agent" title="Prokinetic agent">prokinetic agents</a>.<sup id="cite_ref-Francis_Zavala_2023_r880_2-2" class="reference"><a href="#cite_note-Francis_Zavala_2023_r880-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">15% to 20% of patients have persistent symptoms during extended follow-up.<sup id="cite_ref-Francis_Zavala_2023_r880_2-3" class="reference"><a href="#cite_note-Francis_Zavala_2023_r880-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">5-11% worldwide.<sup id="cite_ref-uptodate.com_a625_1-4" class="reference"><a href="#cite_note-uptodate.com_a625-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Functional dyspepsia</b> (<b>FD</b>) is a common <a href="/wiki/Gastrointestinal_disease" title="Gastrointestinal disease">gastrointestinal disorder</a> defined by symptoms arising from the gastroduodenal region in the absence of an underlying organic disease that could easily explain the symptoms.<sup id="cite_ref-past,_present_3-0" class="reference"><a href="#cite_note-past,_present-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Characteristic symptoms include epigastric burning, <a href="/wiki/Abdominal_pain" title="Abdominal pain">epigastric pain</a>, postprandial fullness, and early satiety. FD was formerly known as <b>non-ulcer dyspepsia</b>, as opposed to "<a href="/wiki/Organic_dyspepsia" class="mw-redirect" title="Organic dyspepsia">organic dyspepsia</a>" with underlying conditions of <a href="/wiki/Gastritis" title="Gastritis">gastritis</a>, <a href="/wiki/Peptic_ulcer_disease" title="Peptic ulcer disease">peptic ulcer disease</a>, or cancer. </p><p>The exact cause of functional dyspepsia is unknown however there has been many hypotheses regarding the mechanisms. Theories behind the pathophysiology of functional dyspepsia include gastroduodenal motility, gastroduodenal sensitivity, <a href="/wiki/Gut_microbiota" title="Gut microbiota">intestinal microbiota</a>, immune dysfunction, <a href="/wiki/Gut%E2%80%93brain_axis" title="Gut–brain axis">gut-brain axis</a> dysfunction, abnormalities of gastric electrical rhythm, and <a href="/wiki/Autonomic_nervous_system" title="Autonomic nervous system">autonomic nervous system</a>/<a href="/wiki/Central_nervous_system" title="Central nervous system">central nervous system</a> dysregulation. Risk factors for developing functional dyspepsia include female sex, smoking, <a href="/wiki/Nonsteroidal_anti-inflammatory_drug" title="Nonsteroidal anti-inflammatory drug">non-steroidal anti-inflammatory medication</a> use, and <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">H pylori infection</a>. Gastrointestinal infections can trigger the onset of functional dyspepsia. </p><p>Functional dyspepsia is diagnosed based on clinical criteria and symptoms. Depending on the symptoms present people suspected of having FD may need blood work, imaging, or <a href="/wiki/Endoscopy" title="Endoscopy">endoscopies</a> to confirm the diagnosis of functional dyspepsia. Functional dyspepsia is further classified into two subtypes, postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). </p><p>Functional dyspepsia can be managed with medications such as <a href="/wiki/Prokinetic_agent" title="Prokinetic agent">prokinetic agents</a>, fundus-relaxing drugs, centrally acting <a href="/wiki/Neuromodulation" title="Neuromodulation">neuromodulators</a>, and <a href="/wiki/Proton-pump_inhibitor" title="Proton-pump inhibitor">proton pump inhibitors</a>. Up to 15-20% of patients with functional dyspepsia experience persistent symptoms. Functional dyspepsia is more common in women than men. In Western nations, the prevalence is believed to be 10-40% and 5-30% in Asian nations. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Symptoms of functional dyspepsia include epigastric burning, <a href="/wiki/Abdominal_pain" title="Abdominal pain">epigastric pain</a>, postprandial fullness (often described as <a href="/wiki/Bloating" title="Bloating">bloating</a> by those who have FD), and early satiety.<sup id="cite_ref-Essential_Medical_4-0" class="reference"><a href="#cite_note-Essential_Medical-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Food consumption frequently makes symptoms worse.<sup id="cite_ref-Pathophysiology_and_treatment_5-0" class="reference"><a href="#cite_note-Pathophysiology_and_treatment-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Although functional dyspepsia is typically chronic, the symptoms are generally sporadic, even during periods of severe symptoms.<sup id="cite_ref-Natural_history_6-0" class="reference"><a href="#cite_note-Natural_history-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Those with FD typically refer to early satiety as a vague abundance of gas after eating or discomfort, but in reality, what they truly mean is that they find it difficult to finish a normal-sized meal because they are uncomfortable or feel full.<sup id="cite_ref-Essential_Medical_4-1" class="reference"><a href="#cite_note-Essential_Medical-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>While <a href="/wiki/Nausea" title="Nausea">nausea</a> and <a href="/wiki/Heartburn" title="Heartburn">heartburn</a> are still possible co-occurring symptoms, they are no longer regarded as major dyspeptic symptoms and may originate from different processes. When certain symptoms occur, such as <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, a coexisting or alternative condition, like <a href="/wiki/Gastroparesis" title="Gastroparesis">gastroparesis</a>, needs to be evaluated.<sup id="cite_ref-Essential_Medical_4-2" class="reference"><a href="#cite_note-Essential_Medical-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=2" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Functional dyspepsia has a wide range of complex etiologies.<sup id="cite_ref-Diagnosis_and_Treatment_7-0" class="reference"><a href="#cite_note-Diagnosis_and_Treatment-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Gastric motor function abnormalities have long been linked to functional dyspepsia.<sup id="cite_ref-impaired_gastric_accommodation_8-0" class="reference"><a href="#cite_note-impaired_gastric_accommodation-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Food_and_Symptom_Generation_9-0" class="reference"><a href="#cite_note-Food_and_Symptom_Generation-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> However, a study revealed that there was no relationship between symptoms and stomach physiological abnormalities.<sup id="cite_ref-Pathophysiological_Abnormalities_10-0" class="reference"><a href="#cite_note-Pathophysiological_Abnormalities-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> The symptoms are significantly influenced by meal consumption,<sup id="cite_ref-Relationship_between_symptoms_11-0" class="reference"><a href="#cite_note-Relationship_between_symptoms-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> and genetic factors may also play a part.<sup id="cite_ref-Nature_Reviews_12-0" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Risk_factors">Risk factors</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=3" title="Edit section: Risk factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Several epidemiological studies have demonstrated a moderate correlation between dyspepsia in the general population and female sex, smoking, <a href="/wiki/Nonsteroidal_anti-inflammatory_drug" title="Nonsteroidal anti-inflammatory drug">non-steroidal anti-inflammatory medication</a> use, and <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">H pylori infection</a>.<sup id="cite_ref-Global_prevalence_13-0" class="reference"><a href="#cite_note-Global_prevalence-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In one long-term investigation, a high <a href="/wiki/Body_mass_index" title="Body mass index">body mass index</a> was an independent predictor of the emergence of functional dyspepsia.<sup id="cite_ref-poor_quality_of_life_14-0" class="reference"><a href="#cite_note-poor_quality_of_life-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>Since the brain and gut communicate through the <a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis" title="Hypothalamic–pituitary–adrenal axis">hypothalamic-pituitary-adrenal axis</a> and the enteric nerve system, psychological comorbidity plays a significant influence in the development of functional dyspepsia.<sup id="cite_ref-The_Lancet_15-0" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Anxious participants had an eight-fold increased risk of developing functional dyspepsia compared to those without <a href="/wiki/Anxiety" title="Anxiety">anxiety</a> in a population-based survey conducted in <a href="/wiki/Sweden" title="Sweden">Sweden</a>.<sup id="cite_ref-Swedish_Population_16-0" class="reference"><a href="#cite_note-Swedish_Population-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> According to two Australian longitudinal investigations, there are reciprocal effects between the stomach and the brain. Specifically, people who had functional dyspepsia at baseline were more likely than those who did not experience <a href="/wiki/Anxiety" title="Anxiety">anxiety</a> or <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a> during follow-up.<sup id="cite_ref-12-year_17-0" class="reference"><a href="#cite_note-12-year-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-1‐year_18-0" class="reference"><a href="#cite_note-1‐year-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Triggers">Triggers</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=4" title="Edit section: Triggers"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Acute <a href="/wiki/Gastroenteritis" title="Gastroenteritis">gastroenteritis</a> can lead to the development of post-infection functional dyspepsia.<sup id="cite_ref-The_Lancet_15-1" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> According to a meta-analysis of 19 papers, exposed people had nearly three times the chance of developing functional dyspepsia over the course of more than six months following an infection compared to non-exposed people.<sup id="cite_ref-post‐infectious_19-0" class="reference"><a href="#cite_note-post‐infectious-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=5" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Because functional dyspepsia symptoms are complicated and vary so much, the underlying pathophysiology of the disorder is still unknown.<sup id="cite_ref-The_Lancet_15-2" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The causes of dyspeptic symptoms have been attributed to a number of pathophysiologic processes. These include gastroduodenal motility, gastroduodenal sensitivity, <a href="/wiki/Gut_microbiota" title="Gut microbiota">intestinal microbiota</a>, immune dysfunction, <a href="/wiki/Gut%E2%80%93brain_axis" title="Gut–brain axis">gut-brain axis</a> dysfunction, abnormalities of gastric electrical rhythm, and <a href="/wiki/Autonomic_nervous_system" title="Autonomic nervous system">autonomic nervous system</a>/<a href="/wiki/Central_nervous_system" title="Central nervous system">central nervous system</a> dysregulation.<sup id="cite_ref-Pathophysiology_and_treatment_5-1" class="reference"><a href="#cite_note-Pathophysiology_and_treatment-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Nature_Reviews_12-1" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-The_Lancet_15-3" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gastroduodenal_motility">Gastroduodenal motility</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=6" title="Edit section: Gastroduodenal motility"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Patients with functional dyspepsia frequently have sensorimotor abnormalities of the gastroduodenum, including altered motility and pathological reactions to mechanical and chemical stimuli.<sup id="cite_ref-Oustamanolakis_2012_20-0" class="reference"><a href="#cite_note-Oustamanolakis_2012-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>One of the main pathophysiologic mechanisms thought to underlie the symptoms of functional dyspepsia is delayed stomach emptying. Several studies have looked into the connection between the pattern and intensity of symptoms and delayed stomach emptying.<sup id="cite_ref-Gastric_emptying_rate_21-0" class="reference"><a href="#cite_note-Gastric_emptying_rate-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> The proportion of dyspeptic individuals with delayed stomach emptying varies from 20% to 50%, depending on the study.<sup id="cite_ref-Symptoms_associated_with_impaired_22-0" class="reference"><a href="#cite_note-Symptoms_associated_with_impaired-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Disturbed_solid-phase_23-0" class="reference"><a href="#cite_note-Disturbed_solid-phase-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>In response to gastric balloon distension during fasting and following meal intake, patients with functional dyspepsia demonstrate impaired proximal stomach accommodation.<sup id="cite_ref-Relations_between_upper_24-0" class="reference"><a href="#cite_note-Relations_between_upper-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Impaired_accommodation_25-0" class="reference"><a href="#cite_note-Impaired_accommodation-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Due to the poor accommodation, there is a disproportional volume distribution, with the <a href="/wiki/Fundus_(stomach)" class="mw-redirect" title="Fundus (stomach)">fundus</a> volume being less and the antral volume being bigger than usual.<sup id="cite_ref-Dysmotility-Like_Dyspepsia_26-0" class="reference"><a href="#cite_note-Dysmotility-Like_Dyspepsia-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Furthermore, individuals suffering from functional dyspepsia exhibit compromised fundus accommodation in reaction to <a href="/wiki/Duodenum" title="Duodenum">duodenal</a> distension.<sup id="cite_ref-Selective_gastric_hypersensitivity_27-0" class="reference"><a href="#cite_note-Selective_gastric_hypersensitivity-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gastroduodenal_sensitivity">Gastroduodenal sensitivity</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=7" title="Edit section: Gastroduodenal sensitivity"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In functional dyspepsia, the stomach's sensitivity to chemical and mechanical stimuli is changed.<sup id="cite_ref-Nature_Reviews_12-2" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> After fasting and meal consumption, patients with functional dyspepsia exhibit visceral hypersensitivity following gastric fundus distension.<sup id="cite_ref-Oustamanolakis_2012_20-1" class="reference"><a href="#cite_note-Oustamanolakis_2012-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-visceral_perception_28-0" class="reference"><a href="#cite_note-visceral_perception-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Following stomach distension, even patients with normal accommodation experience discomfort.<sup id="cite_ref-Neurohormonal_Factors_29-0" class="reference"><a href="#cite_note-Neurohormonal_Factors-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Additionally, some individuals exhibit hypersensitivity to distension of the <a href="/wiki/Duodenum" title="Duodenum">duodenum</a>,<sup id="cite_ref-peristaltic_reflexes_30-0" class="reference"><a href="#cite_note-peristaltic_reflexes-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Jejunum" title="Jejunum">jejunum</a>,<sup id="cite_ref-Neurohormonal_Factors_29-1" class="reference"><a href="#cite_note-Neurohormonal_Factors-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> or <a href="/wiki/Rectum" title="Rectum">rectal cavity</a>,<sup id="cite_ref-Intolerance_to_visceral_distension_31-0" class="reference"><a href="#cite_note-Intolerance_to_visceral_distension-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> indicating a more widespread sensitization of the central and <a href="/wiki/Autonomic_nervous_system" title="Autonomic nervous system">autonomic nervous systems</a>.<sup id="cite_ref-Nature_Reviews_12-3" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Intestinal_microbiota">Intestinal microbiota</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=8" title="Edit section: Intestinal microbiota"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The small <a href="/wiki/Gut_microbiota" title="Gut microbiota">intestinal microbiota</a> has been identified as a possible contributing factor.<sup id="cite_ref-The_Lancet_15-4" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> In one study, an elevated <a href="/wiki/Duodenum" title="Duodenum">duodenal</a> mucosal bacterial load was inversely connected with quality of life and correlated with meal-related symptoms during a nutritional challenge test, despite the fact that relative bacterial abundance in the <a href="/wiki/Small_intestine" title="Small intestine">small intestine</a> is difficult to interpret.<sup id="cite_ref-small_intestine_32-0" class="reference"><a href="#cite_note-small_intestine-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Bile_acid" title="Bile acid">bile acid</a> pool may vary as a result of <a href="/wiki/Microbiome" title="Microbiome">microbiome</a> modifications brought on by <a href="/wiki/Small_intestine" title="Small intestine">small intestine</a> <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>.<sup id="cite_ref-bile_acids_33-0" class="reference"><a href="#cite_note-bile_acids-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p><p>On the other hand, a decrease in primary <a href="/wiki/Bile_acid" title="Bile acid">bile acid</a> levels may have an impact on the <a href="/wiki/Small_intestine" title="Small intestine">small intestine's</a> microbial diversity, which may promote the proliferation of proinflammatory bacteria and low-grade <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>, both of which may result in the breakdown of the epithelial barrier.<sup id="cite_ref-bile_acids_33-1" class="reference"><a href="#cite_note-bile_acids-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-fecal_bile_acid_profile_34-0" class="reference"><a href="#cite_note-fecal_bile_acid_profile-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p><p>A shift in the ratio of main to secondary <a href="/wiki/Bile_acid" title="Bile acid">bile acids</a> and decreased amounts of total <a href="/wiki/Bile_acid" title="Bile acid">bile acids</a> in certain patients with functional dyspepsia during fasting further suggest the involvement of gastrointestinal microbes.<sup id="cite_ref-bile_salt_concentration_35-0" class="reference"><a href="#cite_note-bile_salt_concentration-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Immune_dysfunction">Immune dysfunction</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=9" title="Edit section: Immune dysfunction"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some other functional gastrointestinal disorders have been linked to low-grade mucosal <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> and elevated quantities of <a href="/wiki/White_blood_cell" title="White blood cell">inflammatory cells</a>, such as intraepithelial <a href="/wiki/Lymphocyte" title="Lymphocyte">lymphocytes</a> and <a href="/wiki/Mast_cell" title="Mast cell">mast cells</a>.<sup id="cite_ref-Mucosal_inflammation_36-0" class="reference"><a href="#cite_note-Mucosal_inflammation-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>The quantity of cell-surface markers needed for more proliferation or differentiation of specialized cells, however, does not increase in functional dyspepsia; rather, it indicates the active state of these cells.<sup id="cite_ref-mucosal_integrity_37-0" class="reference"><a href="#cite_note-mucosal_integrity-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>Reduced expression of two markers—<a href="/wiki/Fas_receptor" title="Fas receptor">FAS</a>, which is involved in <a href="/wiki/Lymphocyte" title="Lymphocyte">lymphocyte</a> <a href="/wiki/Homeostasis" title="Homeostasis">homoeostasis</a> and cell <a href="/wiki/Apoptosis" title="Apoptosis">apoptosis</a>, and <a href="/wiki/HLA-DRA" title="HLA-DRA">HLA-DRA</a>, which is involved in <a href="/wiki/B_cell" title="B cell">B-cell</a> proliferation—has been linked to functional dyspepsia and is thought to reflect changes in duodenal <a href="/wiki/Lymphocyte" title="Lymphocyte">lymphocyte</a> populations.<sup id="cite_ref-T_lymphocytes_38-0" class="reference"><a href="#cite_note-T_lymphocytes-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p><p>Moreover, duodenal <a href="/wiki/Eosinophilia" title="Eosinophilia">eosinophilia</a> has been linked to symptoms of postprandial distress syndrome, as opposed to an increase in <a href="/wiki/Mast_cell" title="Mast cell">mast cells</a>.<sup id="cite_ref-Endoscopic_Population-Based_39-0" class="reference"><a href="#cite_note-Endoscopic_Population-Based-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Duodenal_eosinophilia_40-0" class="reference"><a href="#cite_note-Duodenal_eosinophilia-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Gut-brain_axis_dysfunction">Gut-brain axis dysfunction</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=10" title="Edit section: Gut-brain axis dysfunction"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is a subpopulation of people with functional dyspepsia who have involvement in the <a href="/wiki/Gut%E2%80%93brain_axis" title="Gut–brain axis">gut-brain axis</a>. Through the <a href="/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93adrenal_axis" title="Hypothalamic–pituitary–adrenal axis">hypothalamic-pituitary-adrenal axis</a>, changes in epithelial barrier function brought on by <a href="/wiki/Immune_system" title="Immune system">immune system</a> and <a href="/wiki/Gut_microbiota" title="Gut microbiota">gastrointestinal microbiota</a> disruptions can control gut-brain connections.<sup id="cite_ref-The_Lancet_15-5" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> The mechanisms involving <a href="/wiki/Corticotropin-releasing_hormone" title="Corticotropin-releasing hormone">corticotropin-releasing hormone</a> and stress play a significant part in gastrointestinal permeability.<sup id="cite_ref-Corticotropin-releasing_Factor_41-0" class="reference"><a href="#cite_note-Corticotropin-releasing_Factor-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> This impact has been demonstrated in controlled trials including healthy volunteers under stress as well as in animal models of functional dyspepsia.<sup id="cite_ref-Biobreeding_Rat_42-0" class="reference"><a href="#cite_note-Biobreeding_Rat-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-intestinal_permeability_43-0" class="reference"><a href="#cite_note-intestinal_permeability-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Anatomical and functional connectivity impairments were observed in brain regions important for processing visceral afferent information in patients with functional dyspepsia, according to <a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">MRI</a> results.<sup id="cite_ref-insula_44-0" class="reference"><a href="#cite_note-insula-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Regional_Brain_Activity_45-0" class="reference"><a href="#cite_note-Regional_Brain_Activity-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Abnormalities_of_gastric_electrical_rhythm">Abnormalities of gastric electrical rhythm</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=11" title="Edit section: Abnormalities of gastric electrical rhythm"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Additionally, there is proof that up to two thirds of patients with functional dyspepsia have anomalies in the underlying stomach myoelectrical activity, as determined by cutaneous <a href="/wiki/Electrogastrogram" title="Electrogastrogram">electrogastrography</a>. It is yet unknown how this discovery relates to stomach emptying and symptom patterns. There was no association discovered between the pattern of dyspeptic symptoms and the existence of <a href="/wiki/Electrogastrogram" title="Electrogastrogram">electrogastrography</a> results. There has been good evidence of a relationship between aberrant gastric electrical rhythm and delayed stomach emptying.<sup id="cite_ref-Myoelectrical_Activity_46-0" class="reference"><a href="#cite_note-Myoelectrical_Activity-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Electrogastrography_47-0" class="reference"><a href="#cite_note-Electrogastrography-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Autonomic_nervous_system/central_nervous_system_dysregulation"><span id="Autonomic_nervous_system.2Fcentral_nervous_system_dysregulation"></span>Autonomic nervous system/central nervous system dysregulation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=12" title="Edit section: Autonomic nervous system/central nervous system dysregulation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It has been proposed that certain patients with functional dyspepsia may have anomalies in their <a href="/wiki/Autonomic_nervous_system" title="Autonomic nervous system">autonomic nervous system</a>. Particularly, it has been suggested that efferent vagal dysfunction<sup id="cite_ref-Altered_vagal_48-0" class="reference"><a href="#cite_note-Altered_vagal-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> may be the cause of antral hypomotility<sup id="cite_ref-Low_vagal_tone_49-0" class="reference"><a href="#cite_note-Low_vagal_tone-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> and poor adaption to a meal.<sup id="cite_ref-vagotomy_50-0" class="reference"><a href="#cite_note-vagotomy-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> Additionally, there is proof that psychological variables and both stomach functionality and symptoms of functional dyspepsia are related to psychopathology. Low vagal activity has been suggested as the mediating mechanism in these relationships.<sup id="cite_ref-Low_vagal_activity_51-0" class="reference"><a href="#cite_note-Low_vagal_activity-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Suppression_of_Anger_52-0" class="reference"><a href="#cite_note-Suppression_of_Anger-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=13" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Functional dyspepsia is diagnosed using clinical symptoms and <a href="/wiki/Rome_process" title="Rome process">Rome IV criteria</a>, which were recently revised.<sup id="cite_ref-Gastroduodenal_Disorders_53-0" class="reference"><a href="#cite_note-Gastroduodenal_Disorders-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> The clinical examination and patient history should look for alarm symptoms. Alarm symptoms include <a href="/wiki/Dysphagia" title="Dysphagia">dysphagia</a>, especially if progressive, or <a href="/wiki/Odynophagia" title="Odynophagia">odynophagia</a>, overt <a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">gastrointestinal bleeding</a>, such as <a href="/wiki/Melena" title="Melena">melena</a> or <a href="/wiki/Hematemesis" title="Hematemesis">hematemesis</a>, persistent <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, unintentional <a href="/wiki/Weight_loss" title="Weight loss">weight loss</a>, family history of <a href="/wiki/Stomach_cancer" title="Stomach cancer">gastric</a> or <a href="/wiki/Esophageal_cancer" title="Esophageal cancer">esophageal cancer</a>, palpable abdominal or <a href="/wiki/Abdominal_mass" title="Abdominal mass">epigastric mass</a> or abdominal <a href="/wiki/Adenopathy" class="mw-redirect" title="Adenopathy">adenopathy</a>, and signs of <a href="/wiki/Iron-deficiency_anemia" title="Iron-deficiency anemia">iron-deficiency anemia</a>.<sup id="cite_ref-Nature_Reviews_12-4" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>The diagnostic criteria for functional dyspepsia is as follows:<sup id="cite_ref-Rome_54-0" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>At least one of the following:<sup id="cite_ref-Rome_54-1" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <ol><li>Troublesome postprandial fullness.<sup id="cite_ref-Rome_54-2" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup></li> <li>Troublesome early satiation.<sup id="cite_ref-Rome_54-3" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup></li> <li>Troublesome <a href="/wiki/Abdominal_pain" title="Abdominal pain">epigastric pain</a>.<sup id="cite_ref-Rome_54-4" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup></li> <li>Troublesome epigastric burning.<sup id="cite_ref-Rome_54-5" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup></li></ol> <p>The criteria must be met over the past three months, with the onset of symptoms occurring at least six months before diagnosis and there must be an absence of structural disease evidence that could account for the symptoms, including <a href="/wiki/Upper_endoscopy" class="mw-redirect" title="Upper endoscopy">upper endoscopy</a>.<sup id="cite_ref-Rome_54-6" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p><p>Taking a thorough history that includes all relevant symptoms is the first step in the process. Patients are then categorized into the relevant subtype and any alarm symptoms or indicators that might point to a different diagnosis are reviewed.<sup id="cite_ref-The_Lancet_15-6" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>The following step is a thorough physical examination, which is crucial for a number of reasons. Patients are first reassured by the examination that their problems are being addressed seriously. Second, even in a patient with typical symptoms, the examination may yield results that point to a different diagnosis.<sup id="cite_ref-The_Lancet_15-7" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>Unfortunately, there is currently no reliable biomarker to aid in the diagnosis, and history and clinical examination cannot reliably differentiate functional dyspepsia from organic dyspepsia causes.<sup id="cite_ref-Distinguish_55-0" class="reference"><a href="#cite_note-Distinguish-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> There is no validated diagnostic algorithm, and current guidelines and the Rome committee oppose routine laboratory testing in all patients.<sup id="cite_ref-Gastroduodenal_Disorders_53-1" class="reference"><a href="#cite_note-Gastroduodenal_Disorders-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ACG_and_CAG_56-0" class="reference"><a href="#cite_note-ACG_and_CAG-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> Requesting a <a href="/wiki/Complete_blood_count" title="Complete blood count">complete blood count</a> is probably a good idea because <a href="/wiki/Anemia" title="Anemia">anemia</a> diagnosis could alter the final diagnosis. <a href="/wiki/Liver_function_tests" title="Liver function tests">Liver function tests</a> are needed if there is concern regarding a potential hepatobiliary cause of severe episodic epigastric discomfort.<sup id="cite_ref-The_Lancet_15-8" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> It is not advised to regularly monitor <a href="/wiki/Thyroid" title="Thyroid">thyroid</a> testing or celiac serology, nor is it advised to frequently screen for <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a> using serum <a href="/wiki/Lipase" title="Lipase">lipase</a> or <a href="/wiki/Amylase" title="Amylase">amylase</a> levels.<sup id="cite_ref-coeliac_disease_57-0" class="reference"><a href="#cite_note-coeliac_disease-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p><p>While a negative <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a> is strictly necessary to validate a functional dyspepsia diagnosis,<sup id="cite_ref-Gastroduodenal_Disorders_53-2" class="reference"><a href="#cite_note-Gastroduodenal_Disorders-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> the majority of dyspepsia patients (80%) have been reported to have no organic abnormalities at <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a>, with under 10 percent having a <a href="/wiki/Peptic_ulcer_disease" title="Peptic ulcer disease">peptic ulcer</a> and fewer than 0,5% having gastro-esophageal cancer.<sup id="cite_ref-Endoscopic_Findings_58-0" class="reference"><a href="#cite_note-Endoscopic_Findings-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> The most recent guidelines for managing dyspepsia prohibit endoscopic use in patients under 60 years of age because its low yield, even in cases where alarm symptoms are present.<sup id="cite_ref-ACG_and_CAG_56-1" class="reference"><a href="#cite_note-ACG_and_CAG-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> Noninvasive <a href="/wiki/Urea_breath_test" title="Urea breath test">urea breath tests</a> or stool antigen testing for <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">H pylori</a> should be performed on these patients.<sup id="cite_ref-The_Lancet_15-9" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> People who have chronic symptoms should be considered candidates for <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a>. Gastric biopsies should also be taken, and if <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">H pylori</a> is found, treatment for the infection should begin.<sup id="cite_ref-ACG_Clinical_Guideline_59-0" class="reference"><a href="#cite_note-ACG_Clinical_Guideline-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-economic_evaluation_60-0" class="reference"><a href="#cite_note-economic_evaluation-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p><p>Because of the low yield, routinely requesting an <a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">abdominal ultrasound</a> or <a href="/wiki/CT_scan" title="CT scan">CT scan</a> in the absence of alarm symptoms or signs is not advised.<sup id="cite_ref-ultrasound_61-0" class="reference"><a href="#cite_note-ultrasound-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> Up to 25% of individuals with functional dyspepsia display delayed stomach emptying, making gastric emptying investigations of little benefit despite the significant symptom overlap and diagnostic confusion between <a href="/wiki/Gastroparesis" title="Gastroparesis">gastroparesis</a> and functional dyspepsia.<sup id="cite_ref-Pathophysiological_Abnormalities_10-1" class="reference"><a href="#cite_note-Pathophysiological_Abnormalities-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>Differential diagnoses for functional dyspepsia include <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastro-oesophageal reflux disease</a>, medication side effects, chronic <a href="/wiki/Intestinal_ischemia" title="Intestinal ischemia">mesenteric ischemia</a>, symptomatic <a href="/wiki/Gallstone" title="Gallstone">gallstone disease</a>, <a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">sphincter of Oddi dysfunction</a>, <a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">biliary dyskinesia</a>, or <a href="/wiki/Gallbladder_cancer" title="Gallbladder cancer">gallbladder cancer</a>, <a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a>, <a href="/wiki/Peptic_ulcer_disease" title="Peptic ulcer disease">peptic ulcer disease</a> (and infection with <a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a>), infiltrative diseases such as <a href="/wiki/Eosinophilic_gastroenteritis" title="Eosinophilic gastroenteritis">eosinophilic gastroenteritis</a>, <a href="/wiki/Sarcoidosis" title="Sarcoidosis">sarcoidosis</a>, and <a href="/wiki/Amyloidosis" title="Amyloidosis">amyloidosis</a>, gastro-oesophageal <a href="/wiki/Malignancy" title="Malignancy">malignancy</a>, gastrointestinal complications of parasites such as <a href="/wiki/Giardia_duodenalis" title="Giardia duodenalis">giardia lamblia</a>, <a href="/wiki/Strongyloides" title="Strongyloides">strongyloides</a>, and <a href="/wiki/Anisakis" title="Anisakis">anisakiasis</a>, <a href="/wiki/Gastroparesis" title="Gastroparesis">gastroparesis</a>, <a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">chronic pancreatitis</a> or <a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">pancreatic cancer</a>, and <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a>.<sup id="cite_ref-The_Lancet_15-10" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Classification">Classification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=14" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The Rome IV criteria further classifies functional dyspepsia into two subtypes, postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).<sup id="cite_ref-Rome_54-7" class="reference"><a href="#cite_note-Rome-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> Postprandial distress syndrome is marked by dyspeptic symptoms brought on by meals, such as postprandial fullness and early satiety and accounts for 69% of patients with functional dyspepsia. Epigastric pain syndrome is characterized by burning or pain in the <a href="/wiki/Stomach" title="Stomach">stomach</a> that may not always happen after eating and accounts for 7% of patients. 25% of patients have overlapping PDS and EPS.<sup id="cite_ref-Effects_of_Rome_IV_62-0" class="reference"><a href="#cite_note-Effects_of_Rome_IV-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=15" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment for functional dyspepsia involves addressing the predominant symptom or symptoms with a realistic discussion of the limitations of available therapies to manage expectations, as well as providing reassurance that there is no structural cause for the symptoms and an explanation of the pathophysiology and natural history of the disorder.<sup id="cite_ref-The_Lancet_15-11" class="reference"><a href="#cite_note-The_Lancet-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>For individuals with functional dyspepsia who are infected, <a href="/wiki/H._pylori" class="mw-redirect" title="H. pylori">H. pylori</a> eradication treatment is recommended in all guidelines because it can potentially alleviate symptoms and reduce the risk of developing <a href="/wiki/Stomach_cancer" title="Stomach cancer">stomach cancer</a> and <a href="/wiki/Peptic_ulcer_disease" title="Peptic ulcer disease">peptic ulcers</a>.<sup id="cite_ref-Kyoto_63-0" class="reference"><a href="#cite_note-Kyoto-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-eradication_therapy_64-0" class="reference"><a href="#cite_note-eradication_therapy-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p><p>Although they haven't been thoroughly investigated, dietary and lifestyle changes are typically advised. It makes sense to advise patients to eat smaller, more frequent meals and to steer clear of foods that worsen their symptoms.<sup id="cite_ref-Pathophysiology_and_treatment_5-2" class="reference"><a href="#cite_note-Pathophysiology_and_treatment-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Eating less fattening meals may be advised because the <a href="/wiki/Duodenum" title="Duodenum">duodenum's</a> <a href="/wiki/Lipid" title="Lipid">lipid</a> content increases the stomach's mechanosensitivity.<sup id="cite_ref-Nutrient-specific_65-0" class="reference"><a href="#cite_note-Nutrient-specific-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-lipid_infusion_66-0" class="reference"><a href="#cite_note-lipid_infusion-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> Although there is no proof connecting <a href="/wiki/Coffee" title="Coffee">coffee</a> and spicy meals high in <a href="/wiki/Capsaicin" title="Capsaicin">capsaicin</a> to symptoms, they are generally avoided.<sup id="cite_ref-coffee_67-0" class="reference"><a href="#cite_note-coffee-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-red_pepper_68-0" class="reference"><a href="#cite_note-red_pepper-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Prokinetic_agent" title="Prokinetic agent">Prokinetic medications</a> are effective in treating functional dyspepsia by stimulating the contractions of the stomach's <a href="/wiki/Smooth_muscle" title="Smooth muscle">smooth muscle</a> and have been suggested as initial treatments for PDS. Prokinetics include agonists of the <a href="/wiki/5-HT_receptor" title="5-HT receptor">5-HT receptor 4</a> (5-HT4), antagonists of the D(2) <a href="/wiki/Dopamine_receptor_D2" title="Dopamine receptor D2">dopamine receptor</a>, and agonists of the <a href="/wiki/Motilin_receptor" title="Motilin receptor">motilin receptor</a>, such <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a>. There aren't many high-quality trials and there's frequently little evidence in the literature supporting their symptomatic benefit.<sup id="cite_ref-upper_functional_GI_69-0" class="reference"><a href="#cite_note-upper_functional_GI-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Serotonin_receptor_agonist" title="Serotonin receptor agonist">5-HT1A agonists</a>, muscarinic auto-receptor antagonists, and <a href="/wiki/Acetylcholinesterase_inhibitor" title="Acetylcholinesterase inhibitor">acetylcholinesterase inhibitors</a>, such as <a href="/wiki/Acotiamide" title="Acotiamide">acotiamide</a>, can all target impaired stomach accommodation.<sup id="cite_ref-upper_functional_GI_69-1" class="reference"><a href="#cite_note-upper_functional_GI-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> Research has demonstrated that the <a href="/wiki/5-HT1A_agonist" class="mw-redirect" title="5-HT1A agonist">5-HT1A agonists</a> <a href="/wiki/Buspirone" title="Buspirone">buspirone</a>,<sup id="cite_ref-Buspirone_70-0" class="reference"><a href="#cite_note-Buspirone-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Tandospirone" title="Tandospirone">tandospirone</a>,<sup id="cite_ref-Tandospirone_Citrate_71-0" class="reference"><a href="#cite_note-Tandospirone_Citrate-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Acotiamide" title="Acotiamide">acotiamide</a> are beneficial for PDS symptoms.<sup id="cite_ref-acotiamide_72-0" class="reference"><a href="#cite_note-acotiamide-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> </p><p>Numerous, frequently tiny,??? investigations have assessed centrally acting <a href="/wiki/Neuromodulators" class="mw-redirect" title="Neuromodulators">neuromodulators</a> in the context of functional dyspepsia. Its reasoning stems from the common occurrence of psychiatric comorbidity and the theory that visceral hypersensitivity may react to centrally active <a href="/wiki/Neuromodulation" title="Neuromodulation">neuromodulators</a> and play a role in the development of symptoms. These medications are most likely the most helpful for EPS. However, similar to <a href="/wiki/5-HT1A_agonist" class="mw-redirect" title="5-HT1A agonist">5-HT1A agonists</a> that act on stomach accommodation, they may also have therapeutic effects in PDS through their effects on gastrointestinal motility.<sup id="cite_ref-Nature_Reviews_12-5" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> When administered at a modest dosage in the evening, the <a href="/wiki/Antidepressant" title="Antidepressant">antidepressant</a> <a href="/wiki/Mirtazapine" title="Mirtazapine">mirtazapine</a> has demonstrated effectiveness in treating early satiety and <a href="/wiki/Nausea" title="Nausea">nausea</a> in individuals with functional dyspepsia who have lost weight and do not exhibit clinically significant co-occurring <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a> or <a href="/wiki/Anxiety" title="Anxiety">anxiety</a>.<sup id="cite_ref-Mirtazapine_73-0" class="reference"><a href="#cite_note-Mirtazapine-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>The most widely utilized first-line therapy for functional dyspepsia is inhibition of acid secretion.<sup id="cite_ref-Nature_Reviews_12-6" class="reference"><a href="#cite_note-Nature_Reviews-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The results indicate that <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastro-esophageal reflux disease</a> is the principal indication, as response rates are highest (up to 45%) in patients with associated <a href="/wiki/Heartburn" title="Heartburn">heartburn</a>.<sup id="cite_ref-efficacy_of_proton_pump_74-0" class="reference"><a href="#cite_note-efficacy_of_proton_pump-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> Compared to people with PDS, those with EPS are more likely to respond.<sup id="cite_ref-lansoprazole_75-0" class="reference"><a href="#cite_note-lansoprazole-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Outlook">Outlook</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=16" title="Edit section: Outlook"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The natural history of most people with functional dyspepsia is chronic and variable, consisting of periods during which the patient has no symptoms at all interspersed with phases of symptom return.<sup id="cite_ref-NEJM_76-0" class="reference"><a href="#cite_note-NEJM-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> </p><p>According to data from population-based studies, during an extended period of follow-up, 15–20% of patients with functional dyspepsia may experience persistent symptoms, and 50–35% may experience a resolution of symptoms; the remaining 30–35% of patients may experience fluctuating symptoms that meet the criteria for another functional gastrointestinal disorder.<sup id="cite_ref-longitudinal_population-based_77-0" class="reference"><a href="#cite_note-longitudinal_population-based-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </p><p>Functional dyspepsia is a chronic condition, although there is no proof that it is linked to a lower chance of survival.<sup id="cite_ref-Survival_78-0" class="reference"><a href="#cite_note-Survival-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=17" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Regardless of the various functional dyspepsia criteria, the population prevalence of the disorder varies greatly around the world, with high overall rates (10–40%) in Western nations and low overall rates (5–30%) in Asian nations.<sup id="cite_ref-epidemiological_differences_79-0" class="reference"><a href="#cite_note-epidemiological_differences-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> Women are more likely than males to experience functional dyspepsia.<sup id="cite_ref-Women_80-0" class="reference"><a href="#cite_note-Women-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=18" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Functional_gastrointestinal_disorder" title="Functional gastrointestinal disorder">Functional gastrointestinal disorder</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=19" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-uptodate.com_a625-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-uptodate.com_a625_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-uptodate.com_a625_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-uptodate.com_a625_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-uptodate.com_a625_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-uptodate.com_a625_1-4"><sup><i><b>e</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.uptodate.com/contents/functional-dyspepsia-in-adults">"UpToDate"</a>. <i>uptodate.com</i><span class="reference-accessdate">. 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SAGE Publications: 241–250. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2217%2Fwhe.15.88">10.2217/whe.15.88</a>. <a href="/wiki/Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/1959.13%2F1347766">1959.13/1347766</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1745-5065">1745-5065</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Women%27s+Health&rft.atitle=Women+and+Functional+Dyspepsia&rft.volume=12&rft.issue=2&rft.pages=241-250&rft.date=2016&rft_id=info%3Ahdl%2F1959.13%2F1347766&rft.issn=1745-5065&rft_id=info%3Adoi%2F10.2217%2Fwhe.15.88&rft.aulast=Napthali&rft.aufirst=Kate&rft.au=Koloski%2C+Natasha&rft.au=Walker%2C+Marjorie+M&rft.au=Talley%2C+Nicholas+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFunctional+dyspepsia" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=20" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1">Mahadeva, Sanjiv (2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4130971">"Epidemiology of functional dyspepsia: A global perspective"</a>. <i>World Journal of Gastroenterology</i>. <b>12</b> (17). Baishideng Publishing Group Inc.: 2661. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.3748%2Fwjg.v12.i17.2661">10.3748/wjg.v12.i17.2661</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1007-9327">1007-9327</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4130971">4130971</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16718749">16718749</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+Journal+of+Gastroenterology&rft.atitle=Epidemiology+of+functional+dyspepsia%3A+A+global+perspective&rft.volume=12&rft.issue=17&rft.pages=2661&rft.date=2006&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4130971%23id-name%3DPMC&rft.issn=1007-9327&rft_id=info%3Apmid%2F16718749&rft_id=info%3Adoi%2F10.3748%2Fwjg.v12.i17.2661&rft.aulast=Mahadeva&rft.aufirst=Sanjiv&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4130971&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFunctional+dyspepsia" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1">El-Serag, H. B.; Talley, N. J. (2004). "The prevalence and clinical course of functional dyspepsia". <i>Alimentary Pharmacology & Therapeutics</i>. <b>19</b> (6): 643–654. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1365-2036.2004.01897.x">10.1111/j.1365-2036.2004.01897.x</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0269-2813">0269-2813</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15023166">15023166</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Alimentary+Pharmacology+%26+Therapeutics&rft.atitle=The+prevalence+and+clinical+course+of+functional+dyspepsia&rft.volume=19&rft.issue=6&rft.pages=643-654&rft.date=2004&rft.issn=0269-2813&rft_id=info%3Apmid%2F15023166&rft_id=info%3Adoi%2F10.1111%2Fj.1365-2036.2004.01897.x&rft.aulast=El-Serag&rft.aufirst=H.+B.&rft.au=Talley%2C+N.+J.&rfr_id=info%3Asid%2Fen.wikipedia.org%3AFunctional+dyspepsia" class="Z3988"></span></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Functional_dyspepsia&action=edit&section=21" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" 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disorder">Esophageal motility disorder</a> <ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li> <li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li> <li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li> <li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li> <li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li> <li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li> <li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li> <li><a 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href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a> <ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li> <li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy's lesion">Dieulafoy's lesion</a></li></ul></li> <li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a> <ul><li><a class="mw-selflink selflink">Functional dyspepsia</a></li></ul></li> <li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li> <li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li> <li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li> <li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li> <li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li> <li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li> <li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li> <li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li> <li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a> <ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a> <ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li> <li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li> <li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a> <ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling's ulcer">Curling's ulcer</a></li></ul></li> <li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li> <li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li> <li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li> <li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li> <li><a href="/wiki/Whipple%27s_disease" title="Whipple's disease">Whipple's</a></li> <li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li> <li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li> <li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li> <li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Appendicitis" title="Appendicitis">Appendicitis</a></li> <li><a href="/wiki/Colitis" title="Colitis">Colitis</a> <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li> <li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li> <li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li> <li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li> <li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li> <li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li> <li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a> <ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li> <li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a> / <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li> <li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a> / <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li> <li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a> <ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li> <li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li> <li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a> <ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li> <li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li> <li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li> <li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li> <li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li> <li><a href="/wiki/Constipation" title="Constipation">Constipation</a> <ul><li><a href="/wiki/Functional_constipation" title="Functional constipation">Functional</a></li></ul></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> <ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li> <li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a> <ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li> <li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li> <li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a></li> <li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li> <li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li> <li><a href="/wiki/Rectal_stricture" title="Rectal stricture">Rectal stricture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li> <li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li> <li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li> <li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li> <li><a href="/wiki/Anal_stricture" title="Anal stricture">Anal stricture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li> <li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a> <ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li> <li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li> <li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a> <ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> <ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li> <li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li> <li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> <ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a> <ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i> <ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li> <li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li> <li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a> <ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li> <li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a> <ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li> <li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li> <li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li> <li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li> <li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a> <ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li> <li><a href="/wiki/Gallstone" title="Gallstone">Gallstone / Cholelithiasis</a></li> <li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li> <li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li> <li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">Postcholecystectomy syndrome</a></li> <li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bile_duct" title="Bile duct">Bile duct</a>/ <br /> Other <a href="/wiki/Biliary_tree" class="mw-redirect" title="Biliary tree">biliary tree</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholangitis" class="mw-redirect" title="Cholangitis">Cholangitis</a> <ul><li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a></li> <li><a href="/wiki/Secondary_sclerosing_cholangitis" title="Secondary sclerosing cholangitis">Secondary sclerosing cholangitis</a></li> <li><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">Ascending</a></li></ul></li> <li><a href="/wiki/Cholestasis" title="Cholestasis">Cholestasis</a>/<a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi's syndrome">Mirizzi's syndrome</a></li> <li><a href="/wiki/Biliary_fistula" title="Biliary fistula">Biliary fistula</a></li> <li><a href="/wiki/Haemobilia" title="Haemobilia">Haemobilia</a></li></ul> <ul><li><i><a href="/wiki/Common_bile_duct" title="Common bile duct">Common bile duct</a></i> <ul><li><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">Choledocholithiasis</a></li> <li><a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">Biliary dyskinesia</a></li></ul></li> <li><a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">Sphincter of Oddi dysfunction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_disease" title="Pancreatic disease">Pancreatic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a> <ul><li><a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">Acute</a></li> <li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic</a></li> <li><a href="/wiki/Hereditary_pancreatitis" title="Hereditary pancreatitis">Hereditary</a></li> <li><a href="/wiki/Pancreatic_abscess" title="Pancreatic abscess">Pancreatic abscess</a></li></ul></li> <li><a href="/wiki/Pancreatic_pseudocyst" title="Pancreatic pseudocyst">Pancreatic pseudocyst</a></li> <li><a href="/wiki/Exocrine_pancreatic_insufficiency" title="Exocrine pancreatic insufficiency">Exocrine pancreatic insufficiency</a></li> <li><a href="/wiki/Pancreatic_fistula" title="Pancreatic fistula">Pancreatic fistula</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Hernia" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diaphragmatic_hernia" title="Diaphragmatic hernia">Diaphragmatic</a> <ul><li><a href="/wiki/Congenital_diaphragmatic_hernia" title="Congenital diaphragmatic hernia">Congenital</a></li></ul></li> <li><a href="/wiki/Hiatus_hernia" class="mw-redirect" title="Hiatus hernia">Hiatus</a></li></ul> <ul><li><a href="/wiki/Inguinal_hernia" title="Inguinal hernia">Inguinal</a> <ul><li><a href="/wiki/Indirect_inguinal_hernia" class="mw-redirect" title="Indirect inguinal hernia">Indirect</a></li> <li><a href="/wiki/Direct_inguinal_hernia" class="mw-redirect" title="Direct inguinal hernia">Direct</a></li></ul></li> <li><a href="/wiki/Umbilical_hernia" title="Umbilical hernia">Umbilical</a></li> <li><a href="/wiki/Femoral_hernia" title="Femoral hernia">Femoral</a></li> <li><a href="/wiki/Obturator_hernia" title="Obturator hernia">Obturator</a></li> <li><a href="/wiki/Spigelian_hernia" title="Spigelian hernia">Spigelian</a></li></ul> <ul><li><i><a href="/wiki/Lumbar_hernia" class="mw-redirect" title="Lumbar hernia">Lumbar</a></i> <ul><li><a href="/wiki/Petit%27s_hernia" title="Petit's hernia">Petit's</a></li> <li><a href="/wiki/Grynfeltt%E2%80%93Lesshaft_hernia" title="Grynfeltt–Lesshaft hernia">Grynfeltt–Lesshaft</a></li></ul></li></ul> <ul><li><i>Undefined location</i> <ul><li><a href="/wiki/Incisional_hernia" title="Incisional hernia">Incisional</a></li> <li><a href="/wiki/Internal_hernia" title="Internal hernia">Internal hernia</a></li> <li><a href="/wiki/Richter%27s_hernia" title="Richter's hernia">Richter's</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneal_disease" class="mw-redirect" title="Peritoneal disease">Peritoneal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Peritonitis" title="Peritonitis">Peritonitis</a> <ul><li><a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">Spontaneous bacterial peritonitis</a></li></ul></li> <li><a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">Hemoperitoneum</a></li> <li><a href="/wiki/Pneumoperitoneum" title="Pneumoperitoneum">Pneumoperitoneum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Functional_dyspepsia&oldid=1256905086">https://en.wikipedia.org/w/index.php?title=Functional_dyspepsia&oldid=1256905086</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" 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