Treatment of Functional Dyspepsia

Introduction to Treatment Guidelines

• The British Society of Gastroenterology recommends a trial of therapy with the option to stop after initial symptom control, and to restart treatment in case of symptom recurrence 1
• The British Society of Gastroenterology suggests that on-demand therapy with an effective preparation is a valid option for patients with functional dyspepsia 1

First-Line Treatment

• The British Society of Gastroenterology recommends H. pylori testing and eradication as first-line treatment for patients with functional dyspepsia who test positive for H. pylori 1
• For patients with ulcer-like dyspepsia (epigastric pain), the British Society of Gastroenterology recommends proton pump inhibitor (PPI) therapy as first-line treatment 1

Second-Line Treatment

• For patients with dysmotility-type functional dyspepsia (feeling of fullness, early satiation), the British Society of Gastroenterology suggests that prokinetics may be considered as second-line treatment 1
• The British Society of Gastroenterology recommends tricyclic antidepressants in low doses as second-line treatment for patients with refractory symptoms 1

Comparison of Treatments

• Iberogast has been shown to be effective in older studies, with efficacy comparable to metoclopramide 5
• The British Society of Gastroenterology does not explicitly mention Iberogast as a preferred option in modern guidelines, despite its efficacy 1