their doctor first. Medications given to treat FD may
have any of the following adverse effects: skin rashes;
constipationor diarrhea; confusion; higher risk of
osteoporosisand bone fractures; headache; fatigue;
dizziness; and low blood pressure. Cimetidine has
been reported to cause impotence and loss of interest
in sex in males; these symptoms disappear when the
drug is discontinued.Research and general acceptanceA population-based case-control study of adults
in Minnesota found that there was no detectable dif-
ference in the consumption of frequently suspected
culprit foods by patients with FD and the control
subjects. There is also no evidence that a strictly veg-
etarian diet is useful in treating FD. Recent studies
carried out in Germany indicate that a brief period of
fasting under a doctor’s supervision is beneficial to
patients with FD.
Research is ongoing to improve the number and
effectiveness of treatment options for dyspepsia. In
2006, a new drug called itopride was tested for eight
weeks on a group of 523 patients with functional
dyspepsia. The drug requires further study, but the
results of the initial trial are encouraging. Clinical
trials sponsored by the National Institutes of Health
are recruiting subjects to study medications or other
forms of therapy for dyspepsia. They include studies
of the effectiveness of acid-reducing therapy or erad-
ication ofH. pylori, and evaluation of food hyper-
sensitivity in patients with dyspepsia.
In the field of CAM therapies, studies are being
conducted of peppermint oil and turmeric as plant- or
food-based treatments for dyspepsia. With regard to
aloe vera, research indicates that it should not be taken
by mouth as a remedy for dyspepsia because it has
laxative qualities and can lower the body’s absorption
of prescription medications. Other CAM approaches
for dyspepsia being studied are mind/body approaches
like relaxation training, yoga, and hypnosis, and
energy therapies like acupuncture and therapeutic
touch. European studies indicate that hydrotherapy
and massage therapy are beneficial to patients with
functional FD.Resources
BOOKS
Drossman, Douglas A., MD, et al., eds.Rome II: The
Functional Gastrointestinal Disorders, 2nd ed. McLean,
VA: Degnon Associates, Inc., 2002.
Merck Manual of Diagnosis and Treatment, 18th ed. Edited
by Mark H. Beers and Robert Berkow. ‘‘Functional GIIllness.’’ Chapter 7, Section 2. Whitehouse Station, NJ:
Merck, 2007.
Pelletier, Kenneth R., MD.The Best Alternative Medicine,
Part II, ‘‘CAM Therapies for Specific Conditions:
Gastrointestinal (Stomach and Intestinal) Disturban-
ces.’’ New York: Fireside Books, 2002.
PERIODICALS
Bazaldua, Oralia V., and F. David Schneider. ‘‘Evaluation
and Management of Dyspepsia.’’American Family
Physician60 (October 15, 1999): 1773–1788.
Flier, S. N., and S. Rose. ‘‘Is Functional Dyspepsia of Par-
ticular Concern in Women? A Review of Gender Dif-
ferences in Epidemiology, Pathophysiologic
Mechanisms, Clinical Presentation, and Management.’’
American Journal of Gastroenterology101 (December
2006): S644–S653.
Holtmann, G., N. J. Talley, T. Liebregts, et al. ‘‘A Placebo-
Controlled Trial of Itopride in Functional Dyspepsia.’’
New England Journal of Medicine354 (February 23,
2006): 832–840.
Howell, S. C., S. Quine, and N. J. Talley. ‘‘Low Social Class
Is Linked to Upper Gastrointestinal Symptoms in an
Australian Sample of Urban Adults.’’Scandinavian
Journal of Gastroenterology41 (June 2006): 657–666.
McNally, M. A., and N. J. Talley. ‘‘Current Treatments in
Functional Dyspepsia.’’Current Treatment Options in
Gastroenterology10 (March 2007): 157–168.
Moayyedi, P., N. J. Talley, M. B. Fennerty, and N. Vakil.
‘‘Can the Clinical History Distinguish between Organic
and Functional Dyspepsia?’’Journal of the American
Medical Association295 (April 5, 2006): 1566–1576.
Parker, S. K. ‘‘Latest on Complementary and Alternative
Medicine for GI Disorders.’’Digestive Health and
Nutrition8 (March-April 2006): 22–25.
Saito, Y. A., G. R. Locke, III, A. L. Weaver, et al. ‘‘Diet and
Functional Gastrointestinal Disorders: A Population-
Based Case Control Study.’’American Journal of Gas-
troenterology100 (December 2005): 2743–2748.
Talley, Nicholas J., Nimish Vakil, and the Practice Param-
eters Committee of the American College of Gastro-
enterology (ACG). ‘‘Guidelines for the Management of
Dyspepsia.’’American Journal of Gastroenterology 100
(October 2005): 2324–2337.
OTHER
Herbs at a Glance: Aloe Vera.. National Center for Com-
plementary and Alternative Medicine (NCCAM).
December 2006. [cited May 5, 2007].<http://nccam
.nih.gov/health/aloevera/>.
Herbs at a Glance: Peppermint Oil. National Center for
Complementary and Alternative Medicine (NCCAM).
March 2007. [cited May 5, 2007].<http://nccam.nih
.gov/health/peppermintoil/index.htm>.
Herbs at a Glance: Turmeric. National Center for Comple-
mentary and Alternative Medicine (NCCAM). March- [cited May 5, 2007].http://nccam.nih.gov/
health/turmeric/index.htm.
Dyspepsia