Dyspepsia and Appetite Regulation

  • Takashi Akamizu


Dyspepsia includes symptoms of postprandial fullness, early satiety, and epigastric burning/pain, and most patients with dyspepsia have no identifiable cause of their disease, leading to a diagnosis of functional dyspepsia (FD). There are a number of different factors that affect gut activity, but components of the nervous and endocrine systems are essential for normal gut function. Communications between the brain and gut occur via direct neural connections such as the vagus nerve or through endocrine signaling events requiring hormone delivery to the circulation. Disturbance in any part of the process of feeding results in a decline in food intake. With our increasing knowledge of the interactions between the gut and the brain, there is an expanding list of pharmacologic compounds targeting different stage of this pathway. Currently available therapeutic management of dyspepsia, particularly FD, is based on putative underlying pathophysiologic mechanisms, including gastric acid sensitivity, slow gastric emptying, and Helicobacter pylori infection. Additionally, as knowledge is gained about the reaction of patients with functional gastrointestinal (GI) disorders, therapies in development now may become incorporated into the clinical armamentarium. Serotonergic modulators, cholecystokinin (CCK)-1 antagonists, opioid agonists, N-methyl-d-aspartate (NMDA) receptor antagonists, neurokinin (NK) antagonists, capsaicin-like agents, ghrelin or motilin receptor agonists, and antidepressants are among the agents currently under investigation.


Vagus Nerve Functional Dyspepsia Nucleus Tractus Solitarius Area Postrema Visceral Hypersensitivity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Functional dyspepsia




Functional Gastroduodenal disorders


Functional gastrointestinal disorders


Nonulcer dyspepsia


Migrating motor complex




Peptide YY


Glucagon-like protein 1


Pancreatic polypeptide


Selective serotonin reuptake inhibitors








Nucleus Tractus solitarius


Area postrema


Dorsal motor vagal nucleus


Histamine 2


Tricyclic antidepressants


Vanilloid receptor-1


Food and Drug Administration


  1. Allescher HD. Phytomedicine 2006;13(Suppl 5):2–11.PubMedCrossRefGoogle Scholar
  2. Andrews PL, Sanger GJ. Curr Opin Pharmacol. 2002;2:650–6.PubMedCrossRefGoogle Scholar
  3. Banks WA. Physiol Behav. 2006;89:472–6.PubMedCrossRefGoogle Scholar
  4. Boeckxstaens GE, Hirsch DP, Kuiken SD, Heisterkamp SH, Tytgat GN. Am J Gastroenterol. 2002;97:40–8.PubMedCrossRefGoogle Scholar
  5. Bortolotti M, Coccia G, Grossi G, Miglioli M. Aliment Pharmacol Ther. 2002;16:1075–82.PubMedCrossRefGoogle Scholar
  6. Bray GA. Proc Nutr Soc. 2000;59:373–84.PubMedCrossRefGoogle Scholar
  7. Chawla SP, Grunberg SM, Gralla RJ, Hesketh PJ, Rittenberg C, Elmer ME, Schmidt C, Taylor A, Carides AD, Evans JK, Horgan KJ. Cancer 2003;97:2290–300.PubMedCrossRefGoogle Scholar
  8. Cremonini F, Delgado-Aros S, Talley NJ. Best Pract Res Clin Gastroenterol. 2004;18:717–33.PubMedCrossRefGoogle Scholar
  9. Date Y, Murakami N, Toshinai K, Matsukura S, Niijima A, Matsuo H, Kangawa K, Nakazato M. Gastroenterology 2002;123:1120–8.PubMedCrossRefGoogle Scholar
  10. Delgado-Aros S, Chial HJ, Camilleri M, Szarka LA, Weber FT, Jacob J, Ferber I, McKinzie S, Burton DD, Zinsmeister AR. Am J Physiol Gastrointest Liver Physiol. 2003;284:G558–66.PubMedGoogle Scholar
  11. Drossman DA. Gastroenterology 2006;130:1377–90.PubMedCrossRefGoogle Scholar
  12. Ejskjaer N, Vestergaard ET, Hellstrom PM, Gormsen LC, Madsbad S, Madsen JL, Jensen TA, Pezzullo JC, Christiansen JS, Shaughnessy L, Kosutic G. Aliment Pharmacol Ther. 2009.Google Scholar
  13. Feinle C, Meier O, Otto B, D’Amato M, Fried M. Gut 2001;48:347–55.PubMedCrossRefGoogle Scholar
  14. Giardina GA, Gagliardi S, Martinelli M. IDrugs 2003;6:758–72.PubMedGoogle Scholar
  15. Husebye E. Neurogastroenterol Motil. 1999;11:141–61.PubMedCrossRefGoogle Scholar
  16. Jones MP, Dilley JB, Drossman D, Crowell MD. Neurogastroenterol Motil. 2006;18:91–103.PubMedCrossRefGoogle Scholar
  17. Kuiken SD, Lei A, Tytgat GN, Holman R, Boeckxstaens GE. Aliment Pharmacol Ther. 2002;16:1955–62.PubMedCrossRefGoogle Scholar
  18. Kuo B, Camilleri M, Burton D, Viramontes B, McKinzie S, Thomforde G, O’Connor MK, Brinkmann BH. Aliment Pharmacol Ther. 2002;16:225–33.PubMedCrossRefGoogle Scholar
  19. Lankarani KB, Moghadami M, Masoumpoor M, Geramizadeh B, Omrani GR. Dig Liver Dis. 2004;36:717–21.PubMedCrossRefGoogle Scholar
  20. Masuda Y, Tanaka T, Inomata N, Ohnuma N, Tanaka S, Itoh Z, Hosoda H, Kojima M, Kangawa K. Biochem Biophys Res Commun. 2000;276:905–8.PubMedCrossRefGoogle Scholar
  21. McCallum RW, Cynshi O. Aliment Pharmacol Ther. 2007;26:107–16.PubMedCrossRefGoogle Scholar
  22. Mearin F, Cucala M, Azpiroz F, Malagelada JR. Gastroenterology 1991;101:999–1006.PubMedGoogle Scholar
  23. Mertz H, Fass R, Kodner A, Yan-Go F, Fullerton S, Mayer EA. Am J Gastroenterol. 1998;93:160–5.PubMedCrossRefGoogle Scholar
  24. Peeters TL. Neurogastroenterol Motil. 2006;18:1–5.PubMedCrossRefGoogle Scholar
  25. Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, Evans JK, Horgan KJ, Lawson F. Cancer 2003;97:3090–8.PubMedCrossRefGoogle Scholar
  26. Powley TL, Chi MM, Schier LA, Phillips RJ. Physiol Behav. 2005;86:698–708.PubMedCrossRefGoogle Scholar
  27. Read NW, Abitbol JL, Bardhan KD, Whorwell PJ, Fraitag B. Gut 1997;41:664–8.PubMedCrossRefGoogle Scholar
  28. Sanger GJ, Lee K. Nat Rev Drug Discov. 2008;7:241–54.PubMedCrossRefGoogle Scholar
  29. Shinomiya T, Fukunaga M, Akamizu T, Irako T, Yokode M, Kangawa K, Nakai Y. Scand J Gastroenterol. 2005;40:648–53.PubMedCrossRefGoogle Scholar
  30. Suzuki H, Nishizawa T, Hibi T. J Gastroenterol. 2006;41:513–23.PubMedCrossRefGoogle Scholar
  31. Tack J, Peeters T. Gut 2001;49:317–8.PubMedGoogle Scholar
  32. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V. Gastroenterology 2006;130:1466–79.PubMedCrossRefGoogle Scholar
  33. Taguchi A, Sharma N, Saleem RM, Sessler DI, Carpenter RL, Seyedsadr M, Kurz A. N Engl J Med. 2001;345:935–40.PubMedCrossRefGoogle Scholar
  34. Takahashi T, Owyang C. J Physiol. 1997;504(Pt 2):479–88.PubMedCrossRefGoogle Scholar
  35. Talley NJ, Verlinden M, Snape W, Beker JA, Ducrotte P, Dettmer A, Brinkhoff H, Eaker E, Ohning G, Miner PB, Mathias JR, Fumagalli I, Staessen D, Mack RJ. Aliment Pharmacol Ther. 2000;14:1653–61.PubMedCrossRefGoogle Scholar
  36. Talley NJ, Van Zanten SV, Saez LR, Dukes G, Perschy T, Heath M, Kleoudis C, Mangel AW. Aliment Pharmacol Ther. 2001a;15:525–37.PubMedCrossRefGoogle Scholar
  37. Talley NJ, Verlinden M, Geenen DJ, Hogan RB, Riff D, McCallum RW, Mack RJ. Gut 2001b;49:395–401.PubMedCrossRefGoogle Scholar
  38. Talley NJ, Ruff K, Jiang X, Jung HK. Dig Dis. 2008;26:203–9.PubMedCrossRefGoogle Scholar
  39. Zafra MA, Molina F, Puerto A. Neurosci Biobehav Rev. 2006;30:1032–44.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Translational Research CenterKyoto University Hospital, Kyoto University School of MedicineKyotoJapan

Personalised recommendations