Beactivia, probiotics for digestive health

If a worsing of the clinical symptoms or signs is identified, or if the dyspepsia symptoms first occur in those aged greater than 55 years, prompt esophagogastroduodenoscopy is mandatory to exclude serious disease and positively diagnose FD⁽¹⁶⁾. It is recommended that biopsies be routinely obtained at the time of endoscopy to detect Helicobacter pylori infection and, in view of the association of H. pylori with peptic ulcer disease and dyspepsia, eradication is recommended in all positive cases⁽¹⁷⁾. However, there is still a controversial topic, because H. pylori eradication in FD benefits only a minority of cases⁽¹⁶⁾. A Cochrane meta-analysis reported a 8% pooled relative-risk reduction with eradication of H. pylori compared with placebo at 12 months of follow-up⁽¹⁸⁾.

Nevertheless, due to that H. pylori eradication can induce sustained remission in a small minority of patients, this should be routinely considered once the benefit and risks have been carefully discussed with the patient⁽¹⁾.

Several other approaches to FD, including fundus-relaxing drugs, new prokinetics, selective serotonin reuptake inhibitors, and visceral analgesic drugs are currently under investigation⁽¹⁾.