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oai:recercat.cat:11351/128622025-10-24T10:41:03Zcom_2072_378070com_2072_378040col_2072_378092

Updated document on the management of functional dyspepsia by the Asociación Española de Neurogastroenterologia y Motilidad (ASENEM) and Sociedad Española de Medicina Familiar y Comunitaria (semFYC) Serra Pueyo, Jordi Mendive, Juan Santander Vaquero, Cecilio SERRANO FALCON, BLANCA Alcalá-González, Luis Gerardo Atenció primària Dispèpsia - Tractament HEALTH CARE::Health Services Administration::Patient Care Management::Disease Management DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Signs and Symptoms, Digestive::Dyspepsia Other subheadings::Other subheadings::/therapy HEALTH CARE::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health Care ATENCIÓN DE SALUD::administración de los servicios de salud::gestión de la atención al paciente::tratamiento de las enfermedades ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::signos y síntomas digestivos::dispepsia Otros calificadores::Otros calificadores::/terapia ATENCIÓN DE SALUD::administración de los servicios de salud::gestión de la atención al paciente::atención integral de salud::atención primaria de la salud Functional dyspepsia; Management Dispepsia funcional; Manejo Dispèpsia funcional; Maneig Functional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out. The latter has a predominant prokinetic effect, hence it is also used as first-line therapy for patients where early satiety and postprandial fullness predominate. Other therapy alternatives include phytotherapy using STW5 or peppermint/caraway oil, which have shown their superiority over placebo in controlled studies. Concurrently, dietary and lifestyle counseling, as well as psychological interventions such as cognitive-behavioral therapy, when available, may represent a therapeutic alternative worth considering for some patients. Laboratorios Salvat. This document was developed by the Asociación Española de Neurogastroenterologia y Motilidad and the Sociedad Española de Medicina Familiar y Comunitaria. Laboratorios Salvat have not taken part in or influenced in any way the development of the present paper. 2025-10-24T10:41:03Z 2025-10-24T10:41:03Z 2025-10-24T10:41:03Z 2025-04-01T09:33:32Z 2025-04-01T09:33:32Z 2025 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/12862 Revista Española de Enfermedades Digestivas;117(2) https://doi.org/10.17235/reed.2025.10572/2024 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Arán ediciones Scientia