Year 2025 / Volume 117 / Number 2
Review
Updated document on the management of functional dyspepsia by the Asociación Española de Neurogastroenterologia y Motilidad (ASENEM) and Sociedad Española de Medicina Familiar y Comunitaria (semFYC)

84-91

DOI: 10.17235/reed.2025.10572/2024

Jordi Serra, Luis Gerardo Alcalá-González, Juan Manuel Mendive, Cecilio Santander Vaquero, Blanca Serrano Falcón,

Abstract
Functional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out. The latter has a predominant prokinetic effect, hence it is also used as first-line therapy for patients where early satiety and postprandial fullness predominate. Other therapy alternatives include phytotherapy using STW5 or peppermint/caraway oil, which have shown their superiority over placebo in controlled studies. Concurrently, dietary and lifestyle counseling, as well as psychological interventions such as cognitive-behavioral therapy, when available, may represent a therapeutic alternative worth considering for some patients.
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Serra J, Alcalá-González L, Mendive J, Santander Vaquero C, Serrano Falcón B. Updated document on the management of functional dyspepsia by the Asociación Española de Neurogastroenterologia y Motilidad (ASENEM) and Sociedad Española de Medicina Familiar y Comunitaria (semFYC) . 10572/2024


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Publication history

Received: 30/05/2024

Accepted: 19/06/2024

Online First: 15/01/2025

Published: 05/02/2025

Article revision time: 12 days

Article Online First time: 230 days

Article editing time: 251 days


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