Functional dyspepsia: The role of visceral hypersensitivity in its pathogenesis

one study estimated that as many as 25% of Americans may be affected However not all of those affected seek medical attention for their symptoms. While the individual symptoms may be included within the concept of FD are also varied and include post-prandial fullness, bloating, early satiety, nausea, and vomiting, the hallmark of functional dyspepsia is the presence of persistent or recurrent pain or discomfort centred in the upper abdomen for which there is no organic cause. According to the most widely employed definition of FD, Rome , this symptom should have been present for at least 12 wk within the preceding 12 mo in order to be classified as FD The advent and widespread use of the Rome criteria has facilitated clinical studies, including studies of pathophysiology, by ensuring, as far as possible, the inclusion of a relatively homogenous population within any given study. In the evaluation of any study of the role of visceral hypersensitivity, or indeed, any other factor in the pathophysiology of FD, it is critical to be fully apprised, not only of the criteria that were employed in the definition of the study population, but also of their geographic origin and the location of the study. These and other features, such as age, socio-economic status and ethnicity, can lead to tremendous variations in the relative contributions of various factors to the pathophysiology of FD, in a given population. For decades, general practitioners and specialists alike dismissed these patients as malingerers or as having some form of somatization disorder. However, it is only in the last decade or so that attempts have been made to elucidate the true pathophysiology of this heterogeneous disease. A number of putative mechanisms have been elucidated, including visceral hypersensitivity, delayed gastric emptying, impaired gastric accommodation, acid sensitivity, Helicobacter pylori (H pylori) infection and disturbed central perception of peripheral visceral events.