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The treatment sections warrant an important caveat.Recommendations are made based on available data for patients who fail initial standard therapy such as eradication, PPI therapy, and use of a TCA or prokinetic agent.Functional dyspepsia refers to patients with dyspepsia where endoscopy (and other tests where relevant) has ruled out organic pathology that explains the patient’s symptoms.This guideline will focus on initial investigations for dyspepsia such as treatment, PPIs, and prokinetic therapy.

The Rome committee has developed iterative definitions of dyspepsia that have become more specific culminating in Rome IV (ref. These definitions have attempted to minimize the inclusion of gastro-esophageal reflux disease in those with dyspepsia by excluding patients with heartburn and acid regurgitation (15).The assumption of this latter point is that patients that continue to consult due to persistent symptoms desire further treatment.The global literature was reviewed and this guideline takes an international perspective.“Stomach disorders” became an obsession of developed countries in the eighteenth century (2) when the term dyspepsia was first coined (3).A systematic review (4) reported that ~20% of the population has symptoms of dyspepsia globally.

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