Therapeutic strategies for functional dyspepsia and the introduction of the Rome III classification, Gastroenterology, 2006

Although placebo response rates in clinical trials for
functional dyspepsia (FD) are more than 30%, a recent
meta-analysis based on randomized controlled trials
(RCTs) showed that antisecretory drugs were more or
less superior to placebos. On the other hand, large-scale
RCTs on the efficacy of treatment with prokinetics on
FD are still needed. Indications for antibiotic eradication
therapy for Helicobacter pylori-positive FD are still
controversial, but there seems to be a small but significant
therapeutic gain achieved with H. pylori eradication.
Since preprandial and postprandial symptomatic
disturbances are very important targets for FD treatment,
ghrelin, a novel appetite-promoting gastrointestinal
peptide that also promotes gastric motility or basal
acid secretion can be expected to be a therapeutic target.
In the recently published Rome III classification,
FD is redefined for patients with symptoms thought to
originate from the gastroduodenal region, specifically
epigastric pain or burning, postprandial fullness, or
early satiation, and it is divided into the subcategories
postprandial distress syndrome and epigastric pain
syndrome. These new criteria are of value in clinical
practice, for epidemiological, pathophysiological, and
clinical research, and for the development of new therapeutic
strategies.
Key words: postprandial distress syndrome (PDS),
epigastric pain syndrome (EPS), prokinetics, ghrelin,
placebo

Authorized only