Dyspepsia: Organic Versus Functional

  title={Dyspepsia: Organic Versus Functional},
  author={Pantelis Oustamanolakis and Jan Tack},
  journal={Journal of Clinical Gastroenterology},
Dyspepsia is the medical term for difficult digestion. It consists of various symptoms in the upper abdomen, such as fullness, discomfort, early satiation, bloating, heartburn, belching, nausea, vomiting, or pain. The prevalence of dyspepsia in the western world is approximately 20% to 25%. Dyspepsia can be divided into 2 main categories: “organic” and “functional dyspepsia” (FD). Organic causes of dyspepsia are peptic ulcer, gastroesophageal reflux disease, gastric or esophageal cancer… 

Functional dyspepsia

Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology:


Functional dyspepsia is a disorder characterized by dyspeptic symptoms which are located in the epigastrium and related to digestion of food in the initial part of the digestive system and its mechanisms need to be fully elucidated to enable finding appropriate therapy for all patient subgroups.

The Diagnosis and Treatment of Functional Dyspepsia.

The impaired quality of life of patients with functional dyspepsia implies the need for definitive establishment of the diagnosis, followed by symptom-oriented treatment for the duration of the symptomatic interval.

Therapeutic Options for Functional Dyspepsia

Functional dyspepsia (FD) is defined by the presence of chronic gastroduodenal symptoms in the absence of organic or systemic disease that explains them, and a negative upper endoscopy. According to

Understanding the Biliary Dyspepsia

  • Hyun-So Kim
  • Medicine
    The Korean Journal of Pancreas and Biliary Tract
  • 2018
Initial treatment of functional biliary disorder is adequate dietary control and medication, but if the symptoms worsened or recurred frequently, laparoscopic cholecystectomy could be performed with gallbladder dyskinesia.

The Role of Diet in Counteracting Gastroparesis

The general principles for treating symptomatic gastroparesis are to reduce symptoms, correct and prevent fluid, electrolyte and nutritional deficiencies, and identify and treat the concomitant comorbidities.

Functional gastroduodenal disorders

Mechanisms of functional nausea and vomiting are poorly understood, and their treatment currently focuses on pharmacological and non-pharmacological therapies, including antidepressants and psychological approaches.

Functional Dyspepsia: An Enigma in a Conundrum

ABSTRACT As defined by Rome III, there are 4 abdominal pain-related functional gastrointestinal disorders in children: irritable bowel syndrome, functional dyspepsia (FD), abdominal migraine, and

Serological assessment of samples from patients complaining of dyspepsia

Using the results from the serological analysis of the patients’ serum the clinician can delineate between gastric atrophy and a normal health stomach usually without the need to refer the patient for endoscopy.

Psychological Distress in Dyspepsia Markku Pajala Psychological Distress in Dyspepsia

It seems, that mental distress and suspicion of serious illness is merely a nonspecific reaction to abdominal symptoms, which does not support the idea of brain-gut axis in functional dyspepsia, and questions the proposed specific link between gut and brain.



Pathophysiology and treatment of functional dyspepsia.

In a study in 30 H. pylori-negative patients with functional dyspepsia ranitidine (150 mg bid) significantly reduced the severity of heartburn, and was most pronounced in patients of the reflux-like subgroup.

Patterns of symptoms in functional dyspepsia: role of Helicobacter pylori infection and delayed gastric emptying

Investigating the association between specific dyspeptic symptoms and Helicobacter pylori infection or delayed gastric emptying found two subsets of FD patients have been identified on the basis of symptoms, and these findings shed some light on possible etiopathogenetic mechanisms of FD.

Diet, Food Intake, and Disturbed Physiology in the Pathogenesis of Symptoms in Functional Dyspepsia

A systematic review of the literature relating to food intake and FD finds that dietary assessments have frequently implicated fatty foods in symptom induction, and these findings are supported by laboratory-based studies, particularly the demonstration that FD patients more often experience symptoms after intraduodenal infusions of fat, than glucose.

Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia.

The increase of intra-balloon pressure over intra-abdominal pressure needed to induce discomfort or pain is the most appropriate expression of sensitivity to gastric distention because it yields a meaningful lower range of normal and it is independent from age and body mass index.

Prolonged duodenal acid perfusion and dyspeptic symptom occurrence in healthy volunteers

Duodenal acid perfusion causes a sensitization to dyspeptic symptoms and induces antral hypomotility and jejunal hypercontractility, and may play a role in the pathophysiology of FD symptoms.

Functional gastroduodenal disorders

A consensus-based approach was applied, supplemented by input from international experts who reviewed the report, and a dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom.

Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia.

Female sex, relevant and severe postprandial fullness, and severe vomiting are independently associated with delayed gastric emptying of solids in patients with functional dyspepsia seen in a referral center.

Clinical and pathophysiological characteristics of acute-onset functional dyspepsia.

A subset of dyspeptic patients has a history suggestive of postinfectious dyspepsia and has a high prevalence of impaired accommodation attributable to a dysfunction at the level of gastric nitrergic neurons, according to this study.

Symptoms and visceral perception in severe functional and organic dyspepsia

Alterations in the perception of gastric distension distinguishes between functional and organic dyspepsia, while symptoms do not.

Impact of Coexisting Irritable Bowel Syndrome on Symptoms and Pathophysiological Mechanisms in Functional Dyspepsia

Functional dyspepsia + IBS is more prevalent in female patients and is associated with a higher weight loss, with greater overall symptom severity, and with hypersensitivity to distention.