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Functional dyspepsia - Treatment
Last reviewed: 04.07.2025
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Goals of treatment for functional dyspepsia
Reduction of clinical symptoms. Prevention of relapses.
Indications for hospitalization
Hospitalization is indicated when a complex examination is required and there are difficulties in differential diagnosis.
Treatment of patients with functional dyspepsia syndrome should be comprehensive and include measures to normalize lifestyle, diet and nutrition, drug therapy, and, if necessary, psychotherapeutic methods.
Non-drug treatment of functional dyspepsia
Mode
Changing your lifestyle involves eliminating physical and emotional stress that can negatively affect gastrointestinal motility, and eliminating smoking and alcohol.
Diet
Avoid long breaks between meals, consumption of fatty and spicy foods, preservatives, marinades, smoked foods, coffee, and carbonated drinks.
Take food in small portions, chew thoroughly and swallow evenly.
Drug therapy for functional dyspepsia
Prescribed depending on the variant of the disease. In the ulcer-like variant, antacids are prescribed (aluminum hydroxide + magnesium hydroxide, 1 dose 1.5-2 hours after meals and before bedtime) and antisecretory drugs (proton pump inhibitors are preferable to H2-histamine receptor blockers) in the usual daily dose.
In the case of the dyskinetic variant, prokinetics are prescribed to normalize the motor function of the stomach: domperidone (10 mg 3-4 times a day 15-20 minutes before meals). Domperidone does not penetrate the blood-brain barrier, so it has fewer side effects compared to metoclopramide. In the case of the non-specific variant of functional dyspepsia, prokinetics are prescribed in combination with antisecretory drugs. Functional dyspepsia associated with H. pylori is classified by the Maastricht Consensus III (2005) as a group of diseases in which eradication therapy is advisable, since in some patients (approximately 25%) it contributes to a long-term improvement in well-being and prevents the development of atrophic gastritis or peptic ulcer disease.
Further management of the patient
If some drugs are ineffective in patients with functional dyspepsia without “alarming” signs, a trial treatment is carried out with a drug from another group (prokinetics, H2-histamine receptor antagonists , proton pump inhibitors).
One should be aware of the possibility of bleeding, weight loss and dysphagia. If these symptoms occur, the diagnosis of functional dyspepsia is excluded and the patient is referred for consultation with a gastroenterologist.
In patients who have received eradication therapy, H. pylori testing should be performed to confirm the outcome of eradication therapy.
Patient education
The patient is explained the essence of the diagnostic and therapeutic interventions: dyspepsia at a young age without “alarming” signs is rarely associated with serious gastrointestinal diseases such as stomach cancer, complicated peptic ulcer disease and gastroesophageal reflux disease; dyspepsia can be treated with short-term courses of medication.
Prognosis of functional dyspepsia
Due to the absence of an organic cause of functional dyspepsia, the prognosis can be considered favorable, although the disease worsens the quality of life of patients. Functional dyspepsia is characterized by recurrence of symptoms, so the likelihood of recurrence of the disease after a course of treatment remains.
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