KEY CHALLENGES IN DYSPEPSIA MANAGEMENT

Abstract

Functional dyspepsia is a common gastrointestinal disorder that is further subclassified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). This distinction is based on the predominance of symptoms: PDS is characterized by postprandial bloating and early satiety, whereas EPS is defined primarily by epigastric pain or burning.

The diagnostic evaluation of functional dyspepsia is guided by patient age and the presence of alarm features. Individuals aged 60 years or older, as well as those presenting with red-flag symptoms such as unexplained anemia, warrant prompt assessment with esophagogastroduodenoscopy (EGD) to exclude structural disease. In all patients, Helicobacter pylori infection should be investigated and eradicated if present, given its established role in dyspeptic symptoms.

Therapeutic options for functional dyspepsia include proton pump inhibitors (PPIs), neuromodulators, and prokinetic agents. However, the supporting evidence for these interventions remains limited, and clinical response rates are modest. As such, management often requires a tailored approach, balancing symptom control with patient expectations and ongoing reassessment.