British Society of Gastroenterology guidelines on the management of functional dyspepsia
Functional dyspepsia (FD) is a common disorder of gut–brain interaction, affecting approximately 7% of individuals in the community, with most patients managed in primary care. The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the...
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creator | Black, Christopher J Paine, Peter A Agrawal, Anurag Aziz, Imran Eugenicos, Maria P Houghton, Lesley A Hungin, Pali Overshott, Ross Vasant, Dipesh H Rudd, Sheryl Winning, Richard C Corsetti, Maura Ford, Alexander C |
description | Functional dyspepsia (FD) is a common disorder of gut–brain interaction, affecting approximately 7% of individuals in the community, with most patients managed in primary care. The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the interim, substantial advances have been made in understanding the complex pathophysiology of FD, and there has been a considerable amount of new evidence published concerning its diagnosis and classification, with the advent of the Rome IV criteria, and management. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based diagnosis and treatment of patients. The approach to investigating the patient presenting with dyspepsia is discussed, and efficacy of drugs in FD summarised based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of pairwise and network meta-analyses. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system. These provide both the strength of the recommendations and the overall quality of evidence. Finally, in this guideline, we consider novel treatments that are in development, as well as highlighting areas of unmet need and priorities for future research. |
doi_str_mv | 10.1136/gutjnl-2022-327737 |
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The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the interim, substantial advances have been made in understanding the complex pathophysiology of FD, and there has been a considerable amount of new evidence published concerning its diagnosis and classification, with the advent of the Rome IV criteria, and management. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based diagnosis and treatment of patients. The approach to investigating the patient presenting with dyspepsia is discussed, and efficacy of drugs in FD summarised based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of pairwise and network meta-analyses. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system. These provide both the strength of the recommendations and the overall quality of evidence. Finally, in this guideline, we consider novel treatments that are in development, as well as highlighting areas of unmet need and priorities for future research.</description><identifier>ISSN: 0017-5749</identifier><identifier>ISSN: 1468-3288</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2022-327737</identifier><identifier>PMID: 35798375</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Behavior modification ; Brain research ; Cancer therapies ; Diagnosis ; Diet ; Drug dosages ; Dyspepsia ; Dyspepsia - diagnosis ; Dyspepsia - therapy ; Endoscopy ; functional dyspepsia ; Gastric cancer ; Gastroenterology ; Guidelines ; Histamine ; Humans ; Hypnotherapy ; Irritable bowel syndrome ; Meta-analysis ; Patients ; Primary care ; Societies, Medical ; United Kingdom</subject><ispartof>Gut, 2022-09, Vol.71 (9), p.1697-1723</ispartof><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b563t-f929c31d687b183e5dd04215a38f28b031af4ad1da6953be1fc86676d040027c3</citedby><cites>FETCH-LOGICAL-b563t-f929c31d687b183e5dd04215a38f28b031af4ad1da6953be1fc86676d040027c3</cites><orcidid>0000-0001-6371-4359 ; 0000-0002-5351-0229 ; 0000-0001-5449-3603 ; 0000-0003-3833-2302</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380508/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380508/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35798375$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Black, Christopher J</creatorcontrib><creatorcontrib>Paine, Peter A</creatorcontrib><creatorcontrib>Agrawal, Anurag</creatorcontrib><creatorcontrib>Aziz, Imran</creatorcontrib><creatorcontrib>Eugenicos, Maria P</creatorcontrib><creatorcontrib>Houghton, Lesley A</creatorcontrib><creatorcontrib>Hungin, Pali</creatorcontrib><creatorcontrib>Overshott, Ross</creatorcontrib><creatorcontrib>Vasant, Dipesh H</creatorcontrib><creatorcontrib>Rudd, Sheryl</creatorcontrib><creatorcontrib>Winning, Richard C</creatorcontrib><creatorcontrib>Corsetti, Maura</creatorcontrib><creatorcontrib>Ford, Alexander C</creatorcontrib><title>British Society of Gastroenterology guidelines on the management of functional dyspepsia</title><title>Gut</title><addtitle>Gut</addtitle><addtitle>Gut</addtitle><description>Functional dyspepsia (FD) is a common disorder of gut–brain interaction, affecting approximately 7% of individuals in the community, with most patients managed in primary care. The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the interim, substantial advances have been made in understanding the complex pathophysiology of FD, and there has been a considerable amount of new evidence published concerning its diagnosis and classification, with the advent of the Rome IV criteria, and management. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based diagnosis and treatment of patients. The approach to investigating the patient presenting with dyspepsia is discussed, and efficacy of drugs in FD summarised based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of pairwise and network meta-analyses. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system. These provide both the strength of the recommendations and the overall quality of evidence. Finally, in this guideline, we consider novel treatments that are in development, as well as highlighting areas of unmet need and priorities for future research.</description><subject>Behavior modification</subject><subject>Brain research</subject><subject>Cancer therapies</subject><subject>Diagnosis</subject><subject>Diet</subject><subject>Drug dosages</subject><subject>Dyspepsia</subject><subject>Dyspepsia - diagnosis</subject><subject>Dyspepsia - therapy</subject><subject>Endoscopy</subject><subject>functional dyspepsia</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Guidelines</subject><subject>Histamine</subject><subject>Humans</subject><subject>Hypnotherapy</subject><subject>Irritable bowel syndrome</subject><subject>Meta-analysis</subject><subject>Patients</subject><subject>Primary care</subject><subject>Societies, Medical</subject><subject>United Kingdom</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtr3DAUhUVpSaZJ_kAXxdBNNk51JVuPTSANaRoIdNEWshOyLXs02NJEkgvz76vBeTRZZCUu9ztH53IQ-gT4DICyr8OcNm4sCSakpIRzyt-hFVRM5EmI92iFMfCy5pU8RB9j3GCMhZBwgA5pzaWgvF6hu2_BJhvXxS_fWpN2he-Lax1T8MYlE_zoh10xzLYzo3UmFt4VaW2KSTs9mCkze0E_uzZZ7_RYdLu4Ndto9TH60OsxmpOH9wj9-X71-_JHefvz-uby4rZsakZT2UsiWwodE7wBQU3ddbgiUGsqeiIaTEH3le6g00zWtDHQt4IxzjKFMeEtPULni-92bibTtTlS0KPaBjvpsFNeW_Vy4-xaDf6vklTgGotscPpgEPz9bGJSk42tGUftjJ-jIjkaJ8CxzOiXV-jGzyGfnam8lwxDxd-kmGCSAQOSKbJQbfAxBtM_RQas9vWqpV61r1ct9WbR5_-PfZI89pmBswVops3zt284_gOlrbG4</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Black, Christopher J</creator><creator>Paine, Peter A</creator><creator>Agrawal, Anurag</creator><creator>Aziz, Imran</creator><creator>Eugenicos, Maria P</creator><creator>Houghton, Lesley A</creator><creator>Hungin, Pali</creator><creator>Overshott, Ross</creator><creator>Vasant, Dipesh H</creator><creator>Rudd, Sheryl</creator><creator>Winning, Richard C</creator><creator>Corsetti, Maura</creator><creator>Ford, Alexander C</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6371-4359</orcidid><orcidid>https://orcid.org/0000-0002-5351-0229</orcidid><orcidid>https://orcid.org/0000-0001-5449-3603</orcidid><orcidid>https://orcid.org/0000-0003-3833-2302</orcidid></search><sort><creationdate>20220901</creationdate><title>British Society of Gastroenterology guidelines on the management of functional dyspepsia</title><author>Black, Christopher J ; Paine, Peter A ; Agrawal, Anurag ; Aziz, Imran ; Eugenicos, Maria P ; Houghton, Lesley A ; Hungin, Pali ; Overshott, Ross ; Vasant, Dipesh H ; Rudd, Sheryl ; Winning, Richard C ; Corsetti, Maura ; Ford, Alexander C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b563t-f929c31d687b183e5dd04215a38f28b031af4ad1da6953be1fc86676d040027c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Behavior modification</topic><topic>Brain research</topic><topic>Cancer therapies</topic><topic>Diagnosis</topic><topic>Diet</topic><topic>Drug dosages</topic><topic>Dyspepsia</topic><topic>Dyspepsia - diagnosis</topic><topic>Dyspepsia - therapy</topic><topic>Endoscopy</topic><topic>functional dyspepsia</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Guidelines</topic><topic>Histamine</topic><topic>Humans</topic><topic>Hypnotherapy</topic><topic>Irritable bowel syndrome</topic><topic>Meta-analysis</topic><topic>Patients</topic><topic>Primary care</topic><topic>Societies, Medical</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Black, Christopher J</creatorcontrib><creatorcontrib>Paine, Peter A</creatorcontrib><creatorcontrib>Agrawal, Anurag</creatorcontrib><creatorcontrib>Aziz, Imran</creatorcontrib><creatorcontrib>Eugenicos, Maria P</creatorcontrib><creatorcontrib>Houghton, Lesley A</creatorcontrib><creatorcontrib>Hungin, Pali</creatorcontrib><creatorcontrib>Overshott, Ross</creatorcontrib><creatorcontrib>Vasant, Dipesh H</creatorcontrib><creatorcontrib>Rudd, Sheryl</creatorcontrib><creatorcontrib>Winning, Richard C</creatorcontrib><creatorcontrib>Corsetti, Maura</creatorcontrib><creatorcontrib>Ford, Alexander C</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Black, Christopher J</au><au>Paine, Peter A</au><au>Agrawal, Anurag</au><au>Aziz, Imran</au><au>Eugenicos, Maria P</au><au>Houghton, Lesley A</au><au>Hungin, Pali</au><au>Overshott, Ross</au><au>Vasant, Dipesh H</au><au>Rudd, Sheryl</au><au>Winning, Richard C</au><au>Corsetti, Maura</au><au>Ford, Alexander C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>British Society of Gastroenterology guidelines on the management of functional dyspepsia</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><addtitle>Gut</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>71</volume><issue>9</issue><spage>1697</spage><epage>1723</epage><pages>1697-1723</pages><issn>0017-5749</issn><issn>1468-3288</issn><eissn>1468-3288</eissn><abstract>Functional dyspepsia (FD) is a common disorder of gut–brain interaction, affecting approximately 7% of individuals in the community, with most patients managed in primary care. The last British Society of Gastroenterology (BSG) guideline for the management of dyspepsia was published in 1996. In the interim, substantial advances have been made in understanding the complex pathophysiology of FD, and there has been a considerable amount of new evidence published concerning its diagnosis and classification, with the advent of the Rome IV criteria, and management. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based diagnosis and treatment of patients. The approach to investigating the patient presenting with dyspepsia is discussed, and efficacy of drugs in FD summarised based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of pairwise and network meta-analyses. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system. These provide both the strength of the recommendations and the overall quality of evidence. Finally, in this guideline, we consider novel treatments that are in development, as well as highlighting areas of unmet need and priorities for future research.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>35798375</pmid><doi>10.1136/gutjnl-2022-327737</doi><tpages>27</tpages><orcidid>https://orcid.org/0000-0001-6371-4359</orcidid><orcidid>https://orcid.org/0000-0002-5351-0229</orcidid><orcidid>https://orcid.org/0000-0001-5449-3603</orcidid><orcidid>https://orcid.org/0000-0003-3833-2302</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Behavior modification Brain research Cancer therapies Diagnosis Diet Drug dosages Dyspepsia Dyspepsia - diagnosis Dyspepsia - therapy Endoscopy functional dyspepsia Gastric cancer Gastroenterology Guidelines Histamine Humans Hypnotherapy Irritable bowel syndrome Meta-analysis Patients Primary care Societies, Medical United Kingdom |
title | British Society of Gastroenterology guidelines on the management of functional dyspepsia |
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