Treating Fd - Functional Dyspepsia: Digestive Disorders

Content provided by the Faculty of the Harvard Medical School

Treating FD

No truly effective drug exists to treat FD. Still, for some, the knowledge that the condition isn't something more serious may cause the symptoms to disappear or at least become less troublesome. For others, however, the symptoms continue. There's no scientific basis for choosing a specific medication for a person with FD because the stomach and duodenal lining are intact and no pathological problem has been identified.

Many clinical studies show that patients respond no better to drugs than to placebo. It is noteworthy, however, that in almost all clinical trials, 25%–60% of patients respond to medications, and therefore doctors often prescribe them.

People with FD symptoms often try nonprescription medications before seeing a doctor. Antacids, for example, have few side effects and are safe and inexpensive. H₂ blockers are another good choice, usually for short-term treatment. Still other patients find the over-the-counter PPI Prilosec to be effective.

If you seek help from a doctor, you are likely to be tested for H. pylori. If the test is positive (H. pylori bacteria are present), the doctor may recommend eradication therapy — taking two antibiotics plus a PPI for two weeks. If the test is negative, the doctor may recommend a PPI.

For patients who are not helped by PPIs, the doctor may recommend other medications. Anticholinergic medications, such as hyoscyamine (Levsin), that decrease contractions in the GI tract, may be used for up to four to six weeks. Simethicone, which rids the gut of gas bubbles, is safe and can be tried for the patient who complains of dyspepsia and flatulence. Finally, the doctor may prescribe a low dose of a tricyclic antidepressant such as amitriptyline (Elavil, Endep).

Last updated:	August 21, 2007