[Pathogenesis and management of functional dyspepsia].

Functional dyspepsia (FD) is a condition with multifactorial pathogenesis, which includes dysmotility, increase of acid secretion, visceral hypersensitivity, psychological factors, H. pylori infection, genetic alteration, and/or inflammation. FD is common condition also in Japan, and the patients are usually managed as chronic gastritis for the sake of health insurance regulation in primary care setting. Presence of dyspeptic symptoms should be clearly discriminated from histologically defined chronic gastritis. Acid inhibition drugs and use of prokinetics are regarded as two major candidate drugs, yet only limited efficacy of these medicines has been reported by placebo-controlled trials. Although usefulness of other drug options, such as H. pylori eradication, psychotropic drugs, and/or herbal medicine has been reported, more evidence and validation studies for their efficacy are necessary.