Article Text

British Society of Gastroenterology guidelines on the management of functional dyspepsia
  1. Christopher J Black1,2,
  2. Peter A Paine3,4,
  3. Anurag Agrawal5,
  4. Imran Aziz6,7,
  5. Maria P Eugenicos8,
  6. Lesley A Houghton2,
  7. Pali Hungin9,
  8. Ross Overshott10,
  9. Dipesh H Vasant3,11,
  10. Sheryl Rudd12,13,
  11. Richard C Winning12,13,
  12. Maura Corsetti12,13,
  13. Alexander C Ford1,2
  1. 1 Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
  3. 3 Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, UK
  4. 4 Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK
  5. 5 Doncaster and Bassetlaw Hospitals NHS Trust, Doncaster, UK
  6. 6 Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  7. 7 Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, UK
  8. 8 Department of Gastroenterology, University of Edinburgh, Edinburgh, UK
  9. 9 Primary Care and General Practice, University of Newcastle, Newcastle, UK
  10. 10 Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
  11. 11 Neurogastroenterology Unit, Gastroenterology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
  12. 12 NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
  13. 13 University of Nottingham and Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to Professor Alexander C Ford, St James's University Hospital, Leeds LS9 7TF, UK; alexf12399{at}


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.

  • functional dyspepsia
  • meta-analysis

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  • CJB and PAP are joint first authors.

  • MC and ACF are joint senior authors.

  • Twitter @DrCJBlack, @winning_r

  • Contributors Guarantor of the article: ACF is guarantor. Specific author contributions: CB, PAP, AA, IA, MPE, LAH, PH, RO, DHV, SR, RCW, MC and ACF conceived and drafted the study. All authors drafted the manuscript. ACF, MC, CB and PAP edited the manuscript. All authors commented on drafts of the manuscript. All authors have approved the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.