Functional Dyspepsia

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Source: NEJM

Original: https://www.nejm.org/doi/full/10.1056/NEJMx260003?af=R&rss=currentIssue...

Published: 2026-02-04T10:00:07Z

Functional dyspepsia is a common but serious syndrome characterized by unexplained epigastric pain, nausea, and early satiety[2][3]. It affects 7.2% of the world's adult population (10.1% in the US), women 1.6 times more often than men and is more common in people under 40 years of age[2]. It can lead to weight loss, food aversion, increased risk of hospitalization and death[3][7]. It overlaps with other disorders such as irritable bowel syndrome and gastroesophageal reflux, with patients with the overlap having more severe symptoms[3]. It does not have an approved specific treatment; empiric therapy includes acid suppressants, low-dose tricyclic antidepressants, and neuromodulators along with nutritional and psychological support[2][3]. According to Rome IV criteria and normal gastroscopy, it was diagnosed in 3.31% of 302 patients; after 4–6 months, the symptoms did not recur[1]. It probably includes multiple subtypes, including those with local mucosal micro-inflammation caused by an aberrant Th2 response[3]. For refractory symptoms, further testing and multidisciplinary care are recommended[2].