Approach to Functional Dyspepsia

  • Kyung Bong Koh


It is important for physicians to consider psychological factors whenever evaluating patients with functional dyspepsia (FD). Psychosocial factors associated with either the onset or aggravation of FD include negative emotion such as anxiety or depression, stress, personality, coping strategies, and lifestyles. Explanation for symptoms, reassurance, modification of lifestyles, consultation on risk factors, hypnosis, and cognitive behavioral therapy may help treat these patients. A combination of psychotherapy and muscular relaxation helps reduce the onset of pain and relieve symptoms. In FD patients with mild symptoms, reassurance and lifestyle adjustments are often sufficient. For those with more severe or persistent symptoms, it is desirable to use proton pump inhibitors (PPIs), prokinetics, and psychotropic agents. Tricyclic antidepressants can be used for refractory symptoms of FD, especially in epigastric pain syndrome. In addition, mirtazapine is recommended for FD patents with weight loss. Drug-drug interaction needs to be evaluated when considering the combined use of cimetidine and nefazodone/tricyclic antidepressants in FD patients, because of a risk for cumulative drug toxicity.


Functional dyspepsia Psychosocial factors Cognitive behavioral therapy Muscular relaxation Proton pump inhibitors (PPIs) Prokinetics Psychotropic agents Drug-drug interaction 


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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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