S1-Leitlinie der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM) zur funktionellen Dyspepsie (Reizmagen), einer Disorder of Gut-Brain Interaction (DGBI)

Martin Storr; Viola Andresen; Thomas Frieling; Jürgen M. Gschossmann; Jutta Keller; Jost Langhorst; Christian Pehl; Andreas Stengel; Johannes Tebbe; Kai Wiemer; Ahmed Madisch; Miriam Stengel

doi:10.1055/a-2518-1430

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2025; 63(04): 403-422
DOI: 10.1055/a-2518-1430

Leitlinie

S1-Leitlinie der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM) zur funktionellen Dyspepsie (Reizmagen), einer Disorder of Gut-Brain Interaction (DGBI)

Guideline on functional dyspepsia, a disorder of gut-brain-interaction (DGBI): S1 Guideline of the German Society for Neurogastroenterology and Motility (DGNM)

Martin Storr

¹Zentrum für Endoskopie, Internistenzentrum Gauting-Starnberg, Starnberg, Germany

²Medizinische Klinik II der Ludwig-Maximilians Universität München, Germany

,

Viola Andresen

³Facharztpraxis Gastroenterologie, Medizinikum, Hamburg, Germany

,

Thomas Frieling

⁴Helios Klinikum Krefeld, Innere Medizin mit Gastroenterologie, Hepatologie, Infektiologie, Neurogastroenterologie, Gastrointestinaler Onkologie, Hämatoonkologie und Palliativmedizin, Krefeld, Germany

,

Jürgen M. Gschossmann

⁵Klinik für Innere Medizin, Klinikum Forchheim-Fränkische Schweiz, Germany

,

Jutta Keller

⁶Medizinische Klinik, Israelitisches Krankenhaus, Hamburg, Germany

,

Jost Langhorst

⁷Klinik für Integrative Medizin und Naturheilkunde am Klinikum am Bruderwald, Sozialstiftung Bamberg, Germany

⁸Stiftungslehrstuhl für Integrative Medizin, Universität Duisburg-Essen, Klinikum Bamberg, Germany

,

Christian Pehl

⁹Medizinische Klinik, Krankenhaus Vilsbiburg, Germany

,

Andreas Stengel

¹⁰Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum Stuttgart, Germany

¹¹Abteilung Innere Medizin VI, Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Germany

¹²Deutsches Zentrum für Psychische Gesundheit (DZPG), Standort Tübingen, Germany

,

Johannes Tebbe

¹³Klinik für Gastroenterologie und Infektiologie, Klinikum Lippe, Germany

,

Kai Wiemer

¹⁴Medizinische Klinik II – Klinik für Gastroenterologie, Knappschaft Kliniken Kamen, Kamen, Germany

,

Ahmed Madisch

¹⁵Centrum Gastroenterologie Bethanien, Agaplesion Krankenhaus Bethanien, Frankfurt, Germany

,

Miriam Stengel

¹¹Abteilung Innere Medizin VI, Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Germany

¹⁶Medizinische Klinik, SRH Klinik Sigmaringen, Germany

› Author Affiliations

Abstract

Zusammenfassung

Die funktionelle Dyspepsie (FD), der Reizmagen, ist eine häufige Erkrankung und wird zu den Erkrankungen der Darm-Hirn-Interaktionsstörungen, den Disorders of Gut-Brain Interaction (DGBI) gezählt. Die Prävalenz wird mit etwa 10 % der Bevölkerung angegeben. Die Diagnostik erfolgt anhand symptombezogener Kriterien, die sich an den Rom-IV-Kriterien orientieren, in Kombination mit diagnostischen Verfahren, die je nach Symptomausprägung, Dauer und alarmierenden Symptomen Labor, Helicobacter Pylori-Testung, Gastroskopie, Sonografie und weitere Untersuchungen beinhalten. Therapeutische Verfahren umfassen Maßnahmen der Psychoedukation, Ernährungsangebote, Mind-Body-Verfahren, Psychotherapie und medikamentöse Optionen. Die S1-Leitlinie fasst den aktuellen Wissensstand zusammen und erlaubt ein zielgerichtetes Vorgehen, basierend auf der aktuell verfügbaren medizinischen Evidenz.

Abstract

Functional dyspepsia is common and classified as a disorder of gut-brain interaction (DGBI). The prevalence is estimated around 10 % of the population. Diagnosis is based on symptoms, which are based on the Rome IV criteria, in combination with diagnostic procedures that may include laboratory testing, Helicobacter pylori testing, upper gastrointestinal endoscopy, abdominal ultrasound, and other examinations, depending on the severity, duration and presence of alarming symptoms. Therapeutic procedures include psychoeducation, dietary counseling, mind-body procedures, psychotherapy and medication. The S1 guideline summarizes the current state of knowledge and allows a targeted approach based on the currently available medical evidence.

Full Text

References

Literatur
1 Wauters L, Dickman R, Drug V. et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia. United European Gastroenterol J 2021; 9: 307-331
2 Sperber AD, Bangdiwala SI, Drossman DA. et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology 2021; 160: 99-114 e113
3 Ford AC, Marwaha A, Sood R. et al. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut 2015; 64: 1049-1057
4 Futagami S, Itoh T, Sakamoto C. Systematic review with meta-analysis: post-infectious functional dyspepsia. Aliment Pharmacol Ther 2015; 41: 177-188
5 Shaib Y, El-Serag HB. The prevalence and risk factors of functional dyspepsia in a multiethnic population in the United States. Am J Gastroenterol 2004; 99: 2210-2216
6 Aziz I, Palsson OS, Tornblom H. et al. Epidemiology, clinical characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults in the USA, Canada, and the UK: a cross-sectional population-based study. Lancet Gastroenterol Hepatol 2018; 3: 252-262
7 Aro P, Talley NJ, Johansson SE. et al. Anxiety Is Linked to New-Onset Dyspepsia in the Swedish Population: A 10-Year Follow-up Study. Gastroenterology 2015; 148: 928-937
8 Park SY, Acosta A, Camilleri M. et al. Gastric Motor Dysfunction in Patients With Functional Gastroduodenal Symptoms. Am J Gastroenterol 2017; 112: 1689-1699
9 Stanghellini V, Tosetti C. Paternic inverted question mA et al.. Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia. Gastroenterology 1996; 110: 1036-1042
10 Vanheel H, Carbone F, Valvekens L. et al. Pathophysiological Abnormalities in Functional Dyspepsia Subgroups According to the Rome III Criteria. Am J Gastroenterol 2017; 112: 132-140
11 Wauters L, Dickman R, Drug V. et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia. Neurogastroenterol Motil 2021; 33: e14238
12 Schol J, Wauters L, Dickman R. et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. Neurogastroenterol Motil 2021; 33: e14237
13 Pasricha PJ, Grover M, Yates KP. et al. Functional Dyspepsia and Gastroparesis in Tertiary Care are Interchangeable Syndromes With Common Clinical and Pathologic Features. Gastroenterology 2021; 160: 2006-2017
14 Tack J, Piessevaux H, Coulie B. et al. Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology 1998; 115: 1346-1352
15 Simren M, Tornblom H, Palsson OS. et al. Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders: consistent findings from five different patient cohorts. Gut 2018; 67: 255-262
16 Tack J, Caenepeel P, Fischler B. et al. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology 2001; 121: 526-535
17 Oshima T. Functional Dyspepsia: Current Understanding and Future Perspective. Digestion 2024; 105: 26-33
18 Wauters L, Nightingale S, Talley NJ. et al. Functional dyspepsia is associated with duodenal eosinophilia in an Australian paediatric cohort. Aliment Pharmacol Ther 2017; 45: 1358-1364
19 Walker MM, Aggarwal KR, Shim LS. et al. Duodenal eosinophilia and early satiety in functional dyspepsia: confirmation of a positive association in an Australian cohort. J Gastroenterol Hepatol 2014; 29: 474-479
20 Wauters L, Ceulemans M, Frings D. et al. Proton Pump Inhibitors Reduce Duodenal Eosinophilia, Mast Cells, and Permeability in Patients With Functional Dyspepsia. Gastroenterology 2021; 160: 1521-1531.e1529
21 Dellon ES, Peterson KA, Murray JA. et al. Anti-Siglec-8 Antibody for Eosinophilic Gastritis and Duodenitis. N Engl J Med 2020; 383: 1624-1634
22 Holtmann G, Shah A, Morrison M. Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Dig Dis 2017; 35 (Suppl. 01) 5-13
23 Fritscher-Ravens A, Pflaum T, Mösinger M. et al. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology 2019; 157: 109-118.e105
24 Nojkov B, Zhou SY, Dolan RD. et al. Evidence of Duodenal Epithelial Barrier Impairment and Increased Pyroptosis in Patients With Functional Dyspepsia on Confocal Laser Endomicroscopy and "Ex Vivo" Mucosa Analysis. Am J Gastroenterol 2020; 115: 1891-1901
25 Malfertheiner P, Megraud F, Rokkas T. et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut 2022;
26 Hawkings MJ, Vaselli NM, Charalampopoulos D. et al. A Systematic Review of the Prevalence of Persistent Gastrointestinal Symptoms and Incidence of New Gastrointestinal Illness after Acute SARS-CoV-2 Infection. Viruses 2023; 15
27 Saffouri GB, Shields-Cutler RR, Chen J. et al. Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders. Nat Commun 2019; 10: 2012
28 Madisch A, Andresen V, Enck P. et al. The Diagnosis and Treatment of Functional Dyspepsia. Dtsch Arztebl Int 2018; 115: 222-232
29 Song YZ, You HY, Zhu ZH. et al. The C825T Polymorphism of the G-Protein β3 Gene as a Risk Factor for Functional Dyspepsia: A Meta-Analysis. Gastroenterology research and practice 2016; 2016: 5037254
30 Lee HS, An YS, Kang J. et al. Effect of acute auditory stress on gastric motor responses to a meal in healthy volunteers. J Gastroenterol Hepatol 2013; 28: 1699-1704
31 Vanuytsel T, van Wanrooy S, Vanheel H. et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut 2014; 63: 1293-1299
32 Pinto-Sanchez MI, Ford AC, Avila CA. et al. Anxiety and Depression Increase in a Stepwise Manner in Parallel With Multiple FGIDs and Symptom Severity and Frequency. Am J Gastroenterol 2015; 110: 1038-1048
33 Talley NJ. What Causes Functional Gastrointestinal Disorders? A Proposed Disease Model. Am J Gastroenterol 2020; 115: 41-48
34 Stanghellini V, Chan FK, Hasler WL. et al. Gastroduodenal Disorders. Gastroenterology 2016; 150: 1380-1392
35 Enck P, Azpiroz F, Boeckxstaens G. et al. Functional dyspepsia. Nat Rev Dis Primers 2017; 3: 17081
36 Ford AC, Mahadeva S, Carbone MF. et al. Functional dyspepsia. Lancet 2020; 396: 1689-1702
37 Tack J, Talley NJ. Functional dyspepsia – symptoms, definitions and validity of the Rome III criteria. Nature reviews Gastroenterology & hepatology 2013; 10: 134-141
38 Tack J, Talley NJ, Camilleri M. et al. Functional gastroduodenal disorders. Gastroenterology 2006; 130: 1466-1479
39 Karamanolis G, Caenepeel P, Arts J. et al. Association of the predominant symptom with clinical characteristics and pathophysiological mechanisms in functional dyspepsia. Gastroenterology 2006; 130: 296-303
40 Tack J, Schol J, Van den Houte K. et al. Paradigm Shift: Functional Dyspepsia-A "Leaky Gut" Disorder?. Am J Gastroenterol 2021; 116: 274-275
41 Pasricha PJ, Grover M, Yates KP. et al. Functional Dyspepsia and Gastroparesis in Tertiary Care are Interchangeable Syndromes With Common Clinical and Pathologic Features. Gastroenterology 2021; 160: 2006-2017
42 Schol J, Wauters L, Dickman R. et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J 2021; 9: 883-884
43 Gundling F, Frieling T. Kommentiertes Referat: Update Gastroparese 2023: aktuelle Positionspapiere zur Diagnostik und Therapie – individualisierte Therapie eines Krankheitsspektrums. Z Gastroenterol 2024; 62: 224-230
44 Berger MY, van der Velden JJ, Lijmer JG. et al. Abdominal symptoms: do they predict gallstones? A systematic review. Scand J Gastroenterol 2000; 35: 70-76
45 Kraag N, Thijs C, Knipschild P. Dyspepsia – how noisy are gallstones? A meta-analysis of epidemiologic studies of biliary pain, dyspeptic symptoms, and food intolerance. Scand J Gastroenterol 1995; 30: 411-421
46 Black CJ, Paine PA, Agrawal A. et al. British Society of Gastroenterology guidelines on the management of functional dyspepsia. Gut 2022; 71: 1697-1723
47 Moayyedi P, Lacy BE, Andrews CN. et al. ACG and CAG Clinical Guideline: Management of Dyspepsia. Am J Gastroenterol 2017; 112: 988-1013
48 Garcia-Altes A, Rota R, Barenys M. et al. Cost-effectiveness of a 'score and scope' strategy for the management of dyspepsia. Eur J Gastroenterol Hepatol 2005; 17: 709-719
49 Labenz J, Koop H, Madisch A. et al. Gastritis: Update 2020. Gastroenterologie up2date 2020; 16: 277-300
50 Nasseri-Moghaddam S, Mousavian AH, Kasaeian A. et al. What is the Prevalence of Clinically Significant Endoscopic Findings in Subjects With Dyspepsia? Updated Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2023; 21: 1739-1749 e1732
51 Williams B, Luckas M, Ellingham JH. et al. Do young patients with dyspepsia need investigation?. Lancet 1988; 2: 1349-1351
52 Vakil N, Talley N, van Zanten SV. et al. Cost of detecting malignant lesions by endoscopy in 2741 primary care dyspeptic patients without alarm symptoms. Clin Gastroenterol Hepatol 2009; 7: 756-761
53 Fischbach W, Bornschein J, Hoffmann JC. et al. Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS). Z Gastroenterol 2024; 62: 261-321
54 Broeders B, Carbone F, Balsiger LM. et al. Review article: Functional dyspepsia-a gastric disorder, a duodenal disorder or a combination of both?. Aliment Pharmacol Ther 2023; 57: 851-860
55 Fritscher-Ravens A, Schuppan D, Ellrichmann M. et al. Confocal endomicroscopy shows food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome. Gastroenterology 2014; 147: 1012-1020 e1014
56 Fritscher-Ravens A, Pflaum T, Mosinger M. et al. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology 2019; 157: 109-118 e105
57 Frieling T, Gjini B, Melchior I. et al. Gastrointestinal adverse reaction to food (GARF) and endoscopic confocal laser endomicroscopy (eCLE). Z Gastroenterol 2024;
58 Longstreth GF, Lacy BE. Functional dyspepsia in adults. 2024 www.uptodate.com
59 Layer P, Andresen V, Allescher H. et al. Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastroenterologie und Motilität (DGNM). Z Gastroenterol 2021; 59: 1323-1415
60 Madisch A, Koop H. S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). Z Gastroenterol 2023; 61: 797-798
61 Drossman DA, Tack J. Rome Foundation Clinical Diagnostic Criteria for Disorders of Gut-Brain Interaction. Gastroenterology 2022; 162: 675-679
62 Vakil N, Moayyedi P, Fennerty MB. et al. Limited value of alarm features in the diagnosis of upper gastrointestinal malignancy: systematic review and meta-analysis. Gastroenterology 2006; 131: 390-401
63 Pilichiewicz AN, Feltrin KL, Horowitz M. et al. Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY. Am J Gastroenterol 2008; 103: 2613-2623
64 Ohlsson B. The role of smoking and alcohol behaviour in management of functional gastrointestinal disorders. Best Pract Res Clin Gastroenterol 2017; 31: 545-552
65 Koloski NA, Jones M, Walker MM. et al. Functional dyspepsia is associated with lower exercise levels: A population-based study. United European Gastroenterol J 2020; 8: 577-583
66 Rane SV, Asgaonkar B, Rathi P. et al. Effect of moderate aerobic exercises on symptoms of functional dyspepsia. Indian J Gastroenterol 2021; 40: 189-197
67 Van Oudenhove L, Crowell MD, Drossman DA. et al. Biopsychosocial Aspects of Functional Gastrointestinal Disorders. Gastroenterology 2016;
68 Goebel-Stengel M, Paulsen U, Bennerscheidt P. et al. Patients with functional gastrointestinal disorders-importance of communication between physician and patient assessed in a cross-sectional cohort study. Front Psychiatry 2023; 14: 1252268
69 Rodrigues DM, Motomura DI, Tripp DA. et al. Are psychological interventions effective in treating functional dyspepsia? A systematic review and meta-analysis. J Gastroenterol Hepatol 2021; 36: 2047-2057
70 Mikocka-Walus A, Evans S, Linardon J. et al. Psychotherapy appears to improve symptoms of functional dyspepsia and anxiety: systematic review with meta-analysis. Psychol Health Med 2023; 28: 1309-1335
71 Cheng C, Yang FC, Jun S. et al. Flexible coping psychotherapy for functional dyspeptic patients: a randomized, controlled trial. Psychosom Med 2007; 69: 81-88
72 Haag S, Senf W, Tagay S. et al. Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy?. Aliment Pharmacol Ther 2007; 25: 973-986
73 Haug TT, Wilhelmsen I, Svebak S. et al. Psychotherapy in functional dyspepsia. J Psychosom Res 1994; 38: 735-744
74 Orive M, Barrio I, Orive VM. et al. A randomized controlled trial of a 10 week group psychotherapeutic treatment added to standard medical treatment in patients with functional dyspepsia. J Psychosom Res 2015; 78: 563-568
75 Wilhelmsen I, Haug TT, Ursin H. et al. Effect of short-term cognitive psychotherapy on recurrence of duodenal ulcer: a prospective randomized trial. Psychosom Med 1994; 56: 440-448
76 Xiong Y, Xing H, Hu L. et al. Effects of comfort care on symptoms, gastric motility, and mental state of patients with functional dyspepsia. Medicine (Baltimore) 2019; 98: e16110
77 Dehghanizade Z, Zargar Y, Honarmand MM. et al. The effectiveness of cognitive behavior stress management on functional dyspepsia symptoms. J Adv Med Educ Prof 2015; 3: 45
78 Law M, Pickering I, Bartlett E. et al. Cognitive behavioural therapy-based interventions for gastroduodenal disorders of gut-brain interaction: A systematic review. J Psychosom Res 2023; 175: 111516
79 Hamilton J, Guthrie E, Creed F. et al. A randomized controlled trial of psychotherapy in patients with chronic functional dyspepsia. Gastroenterology 2000; 119: 661-669
80 Faramarzi M, Azadfallah P, Book HE. et al. A randomized controlled trial of brief psychoanalytic psychotherapy in patients with functional dyspepsia. Asian J Psychiatr 2013; 6: 228-234
81 Faramarzi M, Azadfallah P, Book HE. et al. The effect of psychotherapy in improving physical and psychiatric symptoms in patients with functional dyspepsia. Iran J Psychiatry 2015; 10: 43-49
82 Chiarioni G, Vantini I, De Iorio F. et al. Prokinetic effect of gut-oriented hypnosis on gastric emptying. Aliment Pharmacol Ther 2006; 23: 1241-1249
83 Calvert EL, Houghton LA, Cooper P. et al. Long-term improvement in functional dyspepsia using hypnotherapy. Gastroenterology 2002; 123: 1778-1785
84 Kinsinger SW, Joyce C, Venu M. et al. Pilot Study of a Self-Administered Hypnosis Intervention for Functional Dyspepsia. Dig Dis Sci 2022; 67: 3017-3025
85 Chiarioni G, Palsson OS, Whitehead WE. Hypnosis and upper digestive function and disease. World J Gastroenterol 2008; 14: 6276-6284
86 Sharma RL. Functional dyspepsia: At least recommend hypnotherapy. BMJ 2008; 337: a1972
87 Storr M. Helicobacter pylori – Update 2013. Med Monatsschr Pharm 2013; 36: 172-176
88 Ford AC, Tsipotis E, Yuan Y. et al. Efficacy of Helicobacter pylori eradication therapy for functional dyspepsia: updated systematic review and meta-analysis. Gut 2022;
89 Masuy I, Van Oudenhove L, Tack J. Review article: treatment options for functional dyspepsia. Aliment Pharmacol Ther 2019; 49: 1134-1172
90 Melzer J, Rosch W, Reichling J. et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004; 20: 1279-1287
91 Koretz RL, Rotblatt M. Complementary and alternative medicine in gastroenterology: the good, the bad, and the ugly. Clin Gastroenterol Hepatol 2004; 2: 957-967
92 Buchert T. Wirkung einer fixen Kombination bei gesicherter Non-Ulcus-Dyspepsie Zeitschrift für Phytotherapie. 1994 ; 15
93 Schnitker J, Schulte-Körne C. Integrierter Abschlussbericht PFK CR-III-003-94 G Biometrischer Teil. Bielefeld: Institut für angewandte Statistik, Schnitker GmbH. In, Report No1. 1999
94 Madisch A, Melderis H, Mayr G. et al. A plant extract and its modified preparation in functional dyspepsia. Results of a double-blind placebo controlled comparative study. Z Gastroenterol 2001; 39: 511-517
95 Rosch W, Vinson B, Sassin I. A randomised clinical trial comparing the efficacy of a herbal preparation STW 5 with the prokinetic drug cisapride in patients with dysmotility type of functional dyspepsia. Z Gastroenterol 2002; 40: 401-408
96 Andresen V, Shah A, Fink C. et al. Efficacy and Safety of STW 5-II for Functional Dyspepsia Treatment: A Patient Data-Based Meta-Analysis. Digestion 2024; 105: 166-174
97 Madisch A, Holtmann G, Mayr G. et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004; 69: 45-52
98 Vinson B, Holtmann G. Efficacy and safety of STW 5 II in patients with functional dyspepsia: results from a double-blind, randomized, multicenter trial. Z Gastroenterol 2020; 58
99 Li K, Lv L, Zhang J. A combination of peppermint oil and caraway oil for the treatment of functional dyspepsia: a systematic review and meta-analysis. Evid Based Complement Alternat Med 2019; 2019: 7654947
100 Madisch A, Frieling T, Zimmermann A. et al. Menthacarin, a Proprietary Peppermint Oil and Caraway Oil Combination, Improves Multiple Complaints in Patients with Functional Gastrointestinal Disorders: A Systematic Review and Meta-Analysis. Dig Dis 2023; 41: 522-532
101 May B, Kuntz HD, Kieser M. et al. Efficacy of a fixed peppermint oil/caraway oil combination in non-ulcer dyspepsia. Arzneimittelforschung 1996; 46: 1149-1153
102 May B, Kohler S, Schneider B. Efficacy and tolerability of a fixed combination of peppermint oil and caraway oil in patients suffering from functional dyspepsia. Aliment Pharmacol Ther 2000; 14: 1671-1677
103 Chey WD, Howden CW, Tack J. et al. Long-term tegaserod treatment for dysmotility-like functional dyspepsia: results of two identical 1-year cohort studies. Dig Dis Sci 2010; 55: 684-697
104 Rich G, Shah A, Koloski N. et al. A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia. Neurogastroenterol Motil 2017; 29
105 Sun XH, Wang ZF, Lin L. Treatment of functional dyspepsia with enteroplant: a multi-center randomized, double-blind, placebo controlled, pilot phase II clinical trial. Chinese Journal of Digestion 2016; 36
106 Storr M, Stracke B. Menthacarin for long-term treatment of functional dyspepsia – Results from a clinical trial follow-up. Z Gastroenterol 2023; 61: 257-267
107 Pinto-Sanchez MI, Yuan Y, Hassan A. et al. Proton pump inhibitors for functional dyspepsia. Cochrane Database Syst Rev 2017; 11: Cd011194
108 Kinoshita Y, Hashimoto T, Kawamura A. et al. Effects of famotidine, mosapride and tandospirone for treatment of functional dyspepsia. Aliment Pharmacol Ther 2005; 21 (Suppl. 02) 37-41
109 Moayyedi P, Soo S, Deeks J. et al. Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev 2006; CD001960
110 Barbara L, Biasco G, Capurso L. et al. Effects of sucralfate and sulglycotide treatment on active gastritis and Helicobacter pylori colonization of the gastric mucosa in non-ulcer dyspepsia patients. Am J Gastroenterol 1990; 85: 1109-1113
111 Mason I, Millar LJ, Sheikh RR. et al. The management of acid-related dyspepsia in general practice: a comparison of an omeprazole versus an antacid-alginate/ranitidine management strategy. Compete Research Group [corrected]. Aliment Pharmacol Ther 1998; 12: 263-271
112 Bashashati M, Hejazi RA, Andrews CN. et al. Gastroesophageal reflux symptoms not responding to proton pump inhibitor: GERD, NERD, NARD, esophageal hypersensitivity or dyspepsia?. Can J Gastroenterol Hepatol 2014; 28: 335-341
113 Yang YJ, Bang CS, Baik GH. et al. Prokinetics for the treatment of functional dyspepsia: Bayesian network meta-analysis. BMC Gastroenterol 2017; 17: 83
114 Qi Q, Wang N, Liu H. et al. Prokinetics for the treatment of functional dyspepsia: an updated systematic review and network meta-analysis. BMC Gastroenterol 2023; 23: 370
115 Storr M, Allescher HD. Motility-modifying drugs. Internist (Berl) 2000; 41: 1318-1324, 1326-1330
116 Storr M, Allescher HD. [Not Available]. Internist (Berl) 2000; 41: 1318-1330
117 Storr M. Ein Therapie-Algorithmus bei Reizmagen. MMW Fortschr Med 2019; 161: 38
118 Holtmann G, Gschossmann J, Mayr P. et al. A randomized placebo-controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia. Alimentary pharmacology & therapeutics 2002; 16: 1641-1648
119 Talley NJ, Locke GR, Saito YA. et al. Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study. Gastroenterology 2015; 149: 340-349 e342
120 Ford AC, Moayyedi P, Black CJ. et al. Systematic review and network meta-analysis: efficacy of drugs for functional dyspepsia. Aliment Pharmacol Ther 2021; 53: 8-21
121 Tack J, Ly HG, Carbone F. et al. Efficacy of Mirtazapine in Patients With Functional Dyspepsia and Weight Loss. Clin Gastroenterol Hepatol 2016; 14: 385-392 e384
122 Mearin F, Rodrigo L, Perez-Mota A. et al. Levosulpiride and cisapride in the treatment of dysmotility-like functional dyspepsia: a randomized, double-masked trial. Clin Gastroenterol Hepatol 2004; 2: 301-308
123 Storr M. Übelkeit und Emesis: An Cannabis denken!. MMW Fortschr Med 2024; 166: 27
124 Venkatesan T, Sengupta J, Lodhi A. et al. An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS). Exp Brain Res 2014; 232: 2563-2570
125 Andrews CN, Devlin SM, Le FollB. et al. Canadian Association of Gastroenterology Position Statement: Use of Cannabis in Gastroenterological and Hepatic Disorders. J Can Assoc Gastroenterol 2019; 2: 37-43
126 Bagherian R, Pourkazem T, Nouri A. The effects of stress management training on symptoms of medical treatment-resistant functional dyspepsia. Govaresh 2011; 14
127 Aucoin M, Lalonde-Parsi MJ, Cooley K. Mindfulness-based therapies in the treatment of functional gastrointestinal disorders: a meta-analysis. Evid Based Complement Alternat Med 2014; 2014: 140724
128 Long X, Liying W, Zhuoran L. et al. The effect of mindfulness-based cognitive therapy on the Clinical efficacy and psychological state in patients with functional dyspepsia. Scand J Gastroenterol 2024; 1-6
129 Casale M, Sabatino L, Moffa A. et al. Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease (GERD): a systematic review. Eur Rev Med Pharmacol Sci 2016; 20: 4547-4552
130 Hjelland IE, Svebak S, Berstad A. et al. Breathing exercises with vagal biofeedback may benefit patients with functional dyspepsia. Scand J Gastroenterol 2007; 42: 1054-1062
131 Tominaga K, Sakata Y, Kusunoki H. et al. Rikkunshito simultaneously improves dyspepsia correlated with anxiety in patients with functional dyspepsia: A randomized clinical trial (the DREAM study). Neurogastroenterol Motil 2018; 30: e13319
132 Miwa H, Nagahara A, Asakawa A. et al. Evidence-based clinical practice guidelines for functional dyspepsia 2021. J Gastroenterol 2022; 57: 47-61
133 Ouyang H, Chen JD. Review article: therapeutic roles of acupuncture in functional gastrointestinal disorders. Aliment Pharmacol Ther 2004; 20: 831-841
134 Takahashi T. Acupuncture for functional gastrointestinal disorders. J Gastroenterol 2006; 41: 408-417
135 Ma TT, Yu SY, Li Y. et al. Randomised clinical trial: an assessment of acupuncture on specific meridian or specific acupoint vs. sham acupuncture for treating functional dyspepsia. Aliment Pharmacol Ther 2012; 35: 552-561
136 Zeng F, Qin W, Ma T. et al. Influence of acupuncture treatment on cerebral activity in functional dyspepsia patients and its relationship with efficacy. Am J Gastroenterol 2012; 107: 1236-1247
137 Zeng F, Lan L, Tang Y. et al. Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia. Neurogastroenterol Motil 2015; 27: 559-568
138 Kim KN, Chung SY, Cho SH. Efficacy of acupuncture treatment for functional dyspepsia: A systematic review and meta-analysis. Complement Ther Med 2015; 23: 759-766
139 Zhou W, Su J, Zhang H. Efficacy and Safety of Acupuncture for the Treatment of Functional Dyspepsia: Meta-Analysis. J Altern Complement Med 2016; 22: 380-389
140 Ho RST, Chung VCH, Wong CHL. et al. Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia: overview of systematic reviews and network meta-analysis. Sci Rep 2017; 7: 10320
141 Liao X, Tian Y, Zhang Y. et al. Acupuncture for functional dyspepsia: Bayesian meta-analysis. Complement Ther Med 2024; 82: 103051
142 Lan L, Zeng F, Liu GJ. et al. Acupuncture for functional dyspepsia. Cochrane Database Syst Rev 2014; 2014: CD008487
143 Chu MHK, Wu IXY, Ho RST. et al. Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews. Therap Adv Gastroenterol 2018; 11: 1756284818785573
144 Ho L, Zhong CCW, Wong CHL. et al. Chinese herbal medicine for functional dyspepsia: a network meta-analysis of prokinetic-controlled randomised trials. Chin Med 2021; 16: 140
145 Bisschops R, Karamanolis G, Arts J. et al. Relationship between symptoms and ingestion of a meal in functional dyspepsia. Gut 2008; 57: 1495-1503
146 Castillo EJ, Camilleri M, Locke GR. et al. A community-based, controlled study of the epidemiology and pathophysiology of dyspepsia. Clin Gastroenterol Hepatol 2004; 2: 985-996
147 Piessevaux H, De Winter B, Louis E. et al. Dyspeptic symptoms in the general population: a factor and cluster analysis of symptom groupings. Neurogastroenterol Motil 2009; 21: 378-388
148 Duncanson KR, Talley NJ, Walker MM. et al. Food and functional dyspepsia: a systematic review. J Hum Nutr Diet 2018; 31: 390-407
149 Saito YA, Locke 3rd GR. et al. Diet and functional gastrointestinal disorders: a population-based case-control study. Am J Gastroenterol 2005; 100: 2743-2748
150 Duncanson K, Burns G, Pryor J. et al. Mechanisms of Food-Induced Symptom Induction and Dietary Management in Functional Dyspepsia. Nutrients 2021; 13: 1109
151 Feinle-Bisset C, Meier B, Fried M. et al. Role of cognitive factors in symptom induction following high and low fat meals in patients with functional dyspepsia. Gut 2003; 52: 1414-1418
152 Bjornsson E, Sjoberg J, Ringstrom G. et al. Effects of duodenal lipids on gastric sensitivity and relaxation in patients with ulcer-like and dysmotility-like dyspepsia. Digestion 2003; 67: 209-217
153 Khodarahmi M, Azadbakht L. Dietary fat intake and functional dyspepsia. Adv Biomed Res 2016; 5: 76
154 Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. Korean J Intern Med 2016; 31: 444-456
155 Halder SL, Locke 3rd GR. et al. Influence of alcohol consumption on IBS and dyspepsia. Neurogastroenterol Motil 2006; 18: 1001-1008
156 Kaess H, Kellermann M, Castro A. Food intolerance in duodenal ulcer patients, non ulcer dyspeptic patients and healthy subjects. A prospective study. Klin Wochenschr 1988; 66: 208-211
157 Talley NJ, McNeil D, Piper DW. Environmental factors and chronic unexplained dyspepsia. Association with acetaminophen but not other analgesics, alcohol, coffee, tea, or smoking. Dig Dis Sci 1988; 33: 641-648
158 Talley NJ, Zinsmeister AR, Schleck CD. et al. Smoking, alcohol, and analgesics in dyspepsia and among dyspepsia subgroups: lack of an association in a community. Gut 1994; 35: 619-624
159 Fuhrer M, Vogelsang H, Hammer J. A placebo-controlled trial of an oral capsaicin load in patients with functional dyspepsia. Neurogastroenterol Motil 2011; 23: 918-e397
160 Hammer J, Fuhrer M. Clinical characteristics of functional dyspepsia depending on chemosensitivity to capsaicin. Neurogastroenterol Motil 2017; 29: 1-12
161 Potter MDE, Walker MM, Jones MP. et al. Wheat Intolerance and Chronic Gastrointestinal Symptoms in an Australian Population-based Study: Association Between Wheat Sensitivity, Celiac Disease and Functional Gastrointestinal Disorders. Am J Gastroenterol 2018; 113: 1036-1044
162 Ford AC, Ching E, Moayyedi P. Meta-analysis: yield of diagnostic tests for coeliac disease in dyspepsia. Aliment Pharmacol Ther 2009; 30: 28-36
163 Elli L, Tomba C, Branchi F. et al. Evidence for the Presence of Non-Celiac Gluten Sensitivity in Patients with Functional Gastrointestinal Symptoms: Results from a Multicenter Randomized Double-Blind Placebo-Controlled Gluten Challenge. Nutrients 2016; 8: 84
164 Staudacher HM, Nevin AN, Duff C. et al. Epigastric symptom response to low FODMAP dietary advice compared with standard dietetic advice in individuals with functional dyspepsia. Neurogastroenterol Motil 2021; 33: e14148
165 Goyal O, Nohria S, Batta S. et al. Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet versus traditional dietary advice for functional dyspepsia: a randomized controlled trial. J Gastroenterol Hepatol 2022; 37: 301-309
166 Pilichiewicz AN, Horowitz M, Holtmann GJ. et al. Relationship between symptoms and dietary patterns in patients with functional dyspepsia. Clin Gastroenterol Hepatol 2009; 7: 317-322
167 Murray HB, Kuo B, Eddy KT. et al. Disorders of gut-brain interaction common among outpatients with eating disorders including avoidant/restrictive food intake disorder. Int J Eat Disord 2021; 54: 952-958
168 Tan VP, Liu KS, Lam FY. et al. Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia. Aliment Pharmacol Ther 2017; 45: 767-776
169 Kang SJ, Park B, Shin CM. Helicobacter pylori Eradication Therapy for Functional Dyspepsia: A Meta-Analysis by Region and H. pylori Prevalence. J Clin Med 2019; 8: 1324
170 Gurusamy SR, Shah A, Talley NJ. et al. Small Intestinal Bacterial Overgrowth in Functional Dyspepsia: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2021; 116: 935-942
171 Zhong L, Shanahan ER, Raj A. et al. Dyspepsia and the microbiome: time to focus on the small intestine. Gut 2017; 66: 1168-1169
172 Zhang Q, Li G, Zhao W. et al. Efficacy of Bifidobacterium animalis subsp. lactis BL-99 in the treatment of functional dyspepsia: a randomized placebo-controlled clinical trial. Nat Commun 2024; 15: 227
173 Wauters L, Van Oudenhove L, Accarie A. et al. Lactobacillus rhamnosus CNCM I-3690 decreases subjective academic stress in healthy adults: a randomized placebo-controlled trial. Gut Microbes 2022; 14: 2031695
174 Wauters L, Slaets H, De Paepe K. et al. Efficacy and safety of spore-forming probiotics in the treatment of functional dyspepsia: a pilot randomised, double-blind, placebo-controlled trial. Lancet Gastroenterol Hepatol 2021; 6: 784-792
175 Brilmayer H, Faust W, Schliemann J. Non-ulcer dyspepsia. Beschwerden und deren medikamentöse Beeinflussung. In: Maiwald, Hrsg. Periodica Medica: Enzynorm® forte – funktionelle Bedeutung und klinische Wirksamkeit. Reinbek: Einhorn Presse Verlag; 1988: 71-85
176 Lynn B. Capsaicin: actions on nociceptive C-fibres and therapeutic potential. Pain 1990; 41: 61-69
177 Holzer P. Capsaicin: cellular targets, mechanisms of action, and selectivity for thin sensory neurons. Pharmacol Rev 1991; 43: 143-201
178 Mayer EA, Gebhart GF. Basic and clinical aspects of visceral hyperalgesia. Gastroenterology 1994; 107: 271-293
179 Capasso F, Gaginella TS, Grandolini G. et al. Phytotherapy. A quick reference to herbal medicine. Heidelberg (Germany): Springer Verlag; 2003
180 Hu ML, Rayner CK, Wu KL. et al. Effect of ginger on gastric motility and symptoms of functional dyspepsia. World J Gastroenterol 2011; 17: 105-110
181 Brown JE, Rice-Evans CA. Luteolin-rich artichoke extract protects low density lipoprotein from oxidation in vitro. Free Radic Res 1998; 29: 247-255
182 Perez-Garcia F, Adzet T, Canigueral S. Activity of artichoke leaf extract on reactive oxygen species in human leukocytes. Free Radic Res 2000; 33: 661-665
183 Rechner AR, Pannala AS, Rice-Evans CA. Caffeic acid derivatives in artichoke extract are metabolised to phenolic acids in vivo. Free Radic Res 2001; 35: 195-202
184 Holtmann G, Adam B, Haag S. et al. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. Aliment Pharmacol Ther 2003; 18: 1099-1105
185 Coffin B, Bortolloti C, Bourgeois O. et al. Efficacy of a simethicone, activated charcoal and magnesium oxide combination (Carbosymag(R)) in functional dyspepsia: results of a general practice-based randomized trial. Clin Res Hepatol Gastroenterol 2011; 35: 494-499
186 Waggershauser CH, Allescher HD, Storr M. Current treatment of dyspepsia in primary care. MMW Fortschr Med 2017; 159: 46-54
187 Olafsdottir LB, Gudjonsson H, Jonsdottir HH. et al. Natural history of functional gastrointestinal disorders: comparison of two longitudinal population-based studies. Dig Liver Dis 2012; 44: 211-217
188 Ford AC, Forman D, Bailey AG. et al. Effect of dyspepsia on survival: a longitudinal 10-year follow-up study. Am J Gastroenterol 2012; 107: 912-921