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Korean J Gastroenterol  <  Volume 73(2); 2019 <  Articles

Korean J Gastroenterol 2019; 73(2): 77-83  https://doi.org/10.4166/kjg.2019.73.2.77
Functional Dyspepsia
Jung Hwan Oh and Joong Goo Kwon1
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul; Department of Internal Medicine, Daegu Catholic University School of Medicine1, Daegu, Korea
Correspondence to: Joong Goo Kwon, Department of Internal Medicine, Daegu Catholic University School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea. Tel: +82-53-650-4215, Fax: +82-53-621-4487, E-mail: kwonjg@cu.ac.kr, ORCID: https://orcid.org/0000-0003-3392-785X
Received: December 28, 2018; Revised: January 28, 2019; Accepted: February 7, 2019; Published online: February 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Dyspepsia is a common problem, and when dyspeptic symptoms develop within a short period of time, organic diseases such as gastroesophageal reflux disease, peptic ulcer diseases, pancreatoduodenal diseases, and gastrointestinal cancers should be suspected. Furthermore, functional dyspepsia (FD) should be considered if chronic or recurrent symptoms persist after eliminating underlying disease. FD is classified as epigastric pain syndrome (EPS) or postprandial distress syndrome (PDS), but these two conditions may overlap. Patients with the EPS subtype can be treated with proton pump inhibitors (PPIs), whereas patients with the PDS subtype may be managed primarily with prokinetics, and patients with EPS and PDS can be co-administered PPIs and prokinetics. Helicobacter pylori eradication therapy can be administered on a test-and-treat basis when PPIs and prokinetics are ineffective or to younger patients with chronic dyspepsia, and tricyclic antidepressants can be used as a secondary treatment because they are effective in patients with the EPS subtype. In addition, because the pathophysiology of FD is diverse, dietary education and stress management are required in addition to medical therapy, and should substantially aid treatment and long-term management. Here, we introduce and summarize recently published guidelines for the treatment of FD.
Keywords: Dyspepsia; Guideline; Helicobacter pylori; Proton pump inhibitors


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