Gastroenterology Research and Practice / 2013 / Article / Tab 2

Review Article

Functional Dyspepsia in Review: Pathophysiology and Challenges in the Diagnosis and Management due to Coexisting Gastroesophageal Reflux Disease and Irritable Bowel Syndrome

Table 2

Summary of proposed mechanisms for functional dyspepsia.

PathogenesisProposed mechanism

Abnormal gastrointestinal motility(i) Abnormal accommodation of gastric fundus [6]
(ii) Delayed gastric emptying [7]
(iii) Rapid gastric emptying [8]

Visceral hypersensitivity(i) Increased sensitivity to mechanical stimulation (gastric dilation) [9]
(ii) Increased sensitivity to chemical stimulation (gastric acid or bile) [10]

Genetic factors(i) Increased risk of FD in patients with polymorphism of G-protein b3 (GNB3) gene [11]
(ii) Increased risk of PDS subtype of FD with polymorphism of serotonin transporter protein (SERT) gene [12]
(iii) Increased risk of EPS subtype of FD with polymorphism of migration inhibitory factor (MIF) gene [13]
(iv) Increased risk of EPS subtype of FD with polymorphism of regulated upon activation of normal T cells expressed and secreted (RANTES) gene [14]

H.  pylori infectionDownregulation of miR-1 and miR-133 caused by H.  pylori infection [15]

Postinfectious causes(i) Increased prevalence of dyspeptic symptoms after infectious gastritis [16]
(ii) Increased expression of interleukin 1β [17]
(iii) Increased infiltration of gastric mucosa with eosinophils, macrophages, and intraepithelial lymphocytes after infection [18]

Psychosocial factors(i) Higher prevalence of psychological symptoms in patient with dyspepsia
(ii) Stress-induced elevated levels of CRH and ACTH which can affect gastric emptying [19]

Other factors(i) Environmental factors
(ii) Dietary exposures

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