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Functional Dyspepsia - Coggle Diagram
Functional Dyspepsia
Therapy
Lifestyle
Regular excercise
No recommendation for specific dietary interventions
Dietician involvement
H. pylori Testing and Eradication (challenged by Swiss guidelines)
Medication
PPI
H2R-Antagonists
Prokinetics (low evidence)
Tricyclic antidepressants (second-line, low dose)
Mirtazapin (second-line, low dose 15 mg daily)
Psychotherapy
Interpersonal psychodynamic psychotherapy
Cognitive behavioural therapy
Stress management
Assess for food intake disorder
Avoid
Opioids
Surgery
Diagnostic criteria (Rome V)
Functional dyspepsia (cirteria vor min. 3 months with onset at least 6 months prior)
Must include 1 or more
Postprandial fullness
Early satiation
Epigastric pain
Epigastric burning
AND
No evidence of structural, systemic or metabolic disease that is likely to explain the symptoms
Postprandial distress Syndrome
1 or both (at least 2 days/week)
Postprandial fullness
Early satiation
No predominance of nausea and vomiting
No evidence of other disease
Epigastric pain Syndrome
1 or both (at least 1 day/week)
Epigastric pain
Epigastric burning
No predominance of nausea/vomiting
No evidence of other disease
If nausea and/or vomiting
Consult Rome V for Nausea and Vomiting Syndromes
Diagnostics
Lab (if age >=55 years)
Full blood count
Coeliac Serology
Upper Endoscopy
If age > 40 years + high risk for gastroesophageal cancer
If age >= 55 years + wheight loss
if age >= 55 years and treatment-resistant/raised platelets/nausea+vomitng
Abdominal CT
If age >= 60 years + abodimanl pain + wheight loss