2016 Volume 56 Issue 10 Pages 977-985
Recently, the Japanese guideline for functional dyspepsia (FD) has been published in 2014, which introduces many papers including randomized placebo controlled studies showing accumulating evidences about the pathogenesis of FD in Japan. However, the pathogenesis of FD still remains unknown. Physiological dysfunctions of gastric acid secretion and gastrointestinal motility may cause dyspeptic symptoms. Therefore, it is focused on the efficacy of acid suppressant and prokinetic agents for the treatment of FD. In addition, it proposes the diagnostic and therapeutic flow for management of patients with dyspepsia. Although this is based on the useful data derived from multiple clinical trials, this flow alone cannot be always effective for all patients with FD. If poor outcomes occur after the recommended treatment using such standard drugs, alternative therapy is required. As a next step after the gastroenterological treatment, psychosomatic treatment is often selected. However, gastroenterologists are generally unfamiliar with psychosomatic treatment. This review summarizes the Japanese guideline for FD and proposes present clinical problems including visceral hypersensitivity in relation to the role of psychology.
