Dyspepsia: An Integrated Review of Diagnosis, Classification, and Mechanisms of Modern and Herbal Medications

https://doi.org/10.22146/farmaseutik.v22i1.105933

Citra Kurnia Solihat(1), Fita Rahmawati(2), Soni Siswanto(3*)

(1) Magister of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(2) Pharmacy Study Program, Sekolah Tinggi Ilmu Kesehatan Notokusumo Yogyakarta
(3) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Dyspepsia is a common and complex disorder characterized by symptoms such as epigastric pain, bloating, and early satiety, which significantly impact patients' quality of life. The pathophysiology of dyspepsia remains poorly understood, with multiple underlying factors including Helicobacter pylori infection, gastric motility disturbances, and visceral hypersensitivity. Modern therapeutic strategies primarily focus on acid suppression and motility enhancement, with Proton Pump Inhibitors (PPIs), H2 blockers, and prokinetic agents as standard treatments. The advent of novel therapies, such as potassium-competitive acid blockers (P-CABs) like Tegoprazan, offers promising alternatives with faster onset and longer-lasting effects. Herbal therapies, including turmeric, ginger, and licorice, have also been explored, showing potential benefits in symptom relief and gastric protection. Despite these advances, the effectiveness of treatment remains variable, and a tailored approach based on patient-specific factors is recommended. This review highlights the current treatment modalities, including both modern and traditional approaches, with a focus on pharmacological and non-pharmacological therapies for dyspepsia.

Keywords


Dyspepsia; Functional Dyspepsia; Proton Pump Inhibitors (PPIs); Tegoprazan; Herbal Medicine

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References

Alqasoumi, S. (2012). Anti-secretagogue and antiulcer effects of Cinnamon Cinnamomum zeylanicum in rats. Journal of Pharmacognosy and Phytotherapy, 4(4), 53–61. https://doi.org/10.5897/JPP12.023

Aregawi, L. G., Shokrolahi, M., Gebremeskel, T. G., & Zoltan, C. (2023). The Effect of Ginger Supplementation on the Improvement of Dyspeptic Symptoms in Patients with Functional Dyspepsia. Cureus, 15(9), e46061. https://doi.org/10.7759/cureus.46061

Aregawi, L. G., Gebremeskel, T. G., & Zoltan, C. (2024). Preventive and therapeutic effects of ginger on bowel disease: A review of clinical trials. Pharmacological Research - Modern Chinese Medicine, 12, 100457. https://doi.org/10.1016/j.prmcm.2024.100457

Aregawi, L. G., & Zoltan, C. (2025). Effects of ginger supplementation on quality of life in patients with functional dyspepsia: An open-label, clinical trial. Advances in Integrative Medicine, 12(4), 100477. https://doi.org/10.1016/j.aimed.2025.100477

Camilleri, M., Parkman, H. P., Shafi, M. A., Abell, T. L., & Gerson, L. (2013). Clinical Guideline: Management of Gastroparesis. Official Journal of the American College of Gastroenterology | ACG, 108(1), 18. https://doi.org/10.1038/ajg.2012.373

Chandrasekaran, C. V., Deepak, H. B., Thiyagarajan, P., Kathiresan, S., Sangli, G. K., Deepak, M., & Agarwal, A. (2011). Dual inhibitory effect of Glycyrrhiza glabra (GutGardTM) on COX and LOX products. Phytomedicine, 18(4), 278–284. https://doi.org/10.1016/j.phymed.2010.08.001

Dehghanizade, Z., Zargar, Y., Mehrabizadeh Honarmand, M., Kadkhodaie, A., & Eydi Baygi, M. (2015). The effectiveness of cognitive behavior stress management on functional dyspepsia symptoms. Journal of Advances in Medical Education & Professionalism, 3(2), 45–49. https://pmc.ncbi.nlm.nih.gov/articles/PMC4403563/

Drossman, D. A., & Hasler, W. L. (2016). Rome IV—Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology, 150(6), 1257–1261. https://doi.org/10.1053/j.gastro.2016.03.035

Dulbecco, P., & Savarino, V. (2013). Therapeutic potential of curcumin in digestive diseases. World Journal of Gastroenterology : WJG, 19(48), 9256–9270. https://doi.org/10.3748/wjg.v19.i48.9256

Ford, A. C., Marwaha, A., Sood, R., & Moayyedi, P. (2015). Global prevalence of, and risk factors for, uninvestigated dyspepsia: A meta-analysis. Gut, 64(7), 1049–1057. https://doi.org/10.1136/gutjnl-2014-307843

Ford, A. C., Mahadeva, S., Carbone, M. F., Lacy, B. E., & Talley, N. J. (2020). Functional dyspepsia. The Lancet, 396(10263), 1689–1702. https://doi.org/10.1016/S0140-6736(20)30469-4

Ford, A. C., Yuan, Y., & Moayyedi, P. (2020). Helicobacter pylori eradication therapy to prevent gastric cancer: Systematic review and meta-analysis. Gut, 69(12), 2113–2121. https://doi.org/10.1136/gutjnl-2020-320839

Francis, P., & Zavala, S. R. (2025). Functional Dyspepsia. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK554563/

Franco, J. V., Arancibia, M., Szeinman, D. J., Alonso, I. T., & Vietto, V. (2019). Herbal (non‐Chinese) medicines for functional dyspepsia. The Cochrane Database of Systematic Reviews, 2019(4), CD013323. https://doi.org/10.1002/14651858.CD013323

Giri, S., Nath, P., Sahu, S., & Anand, A. (2023). How organic is “functional” dyspepsia? : Current understanding and approach to management. Journal of Integrative Medicine and Research, 1, 149–157. https://doi.org/10.4103/jimr.jimr_23_23

Gwee, K., Holtmann, G., Tack, J., Suzuki, H., Liu, J., Xiao, Y., Chen, M., Hou, X., Wu, D., Toh, C., Lu, F., & Tang, X. (2021). Herbal medicines in functional dyspepsia—Untapped opportunities not without risks. Neurogastroenterology and Motility, 33(2), e14044. https://doi.org/10.1111/nmo.14044

Huang, I., Pranata, R., Pangestu, W., Kosasih, F. N., Raffaello, W. M., Yanto, T. A., & Lugito, N. P. H. (2021). The prevalence of uninvestigated dyspepsia and the association of physical exercise with quality of life of uninvestigated dyspepsia patients in Indonesia: An internet-based survey. Indian Journal of Gastroenterology, 40(2), 176–182. https://doi.org/10.1007/s12664-020-01113-z

Huh, C. W., Youn, Y. H., Jung, D. H., Cha, R. R., Kim, Y. J., Jung, K., Song, K. H., Bang, K. B., Tae, C. H., Choi, S. I., Shin, C. M., & Motility, F. D. R. G. U. the K. S. of N. and. (2024). Efficacy of Tegoprazan in Patients With Functional Dyspepsia: A Prospective, Multicenter, Single-arm Study. Journal of Neurogastroenterology and Motility, 30(3), 313–321. https://doi.org/10.5056/jnm23150

Kim, D. K., Lee, K.-H., Kim, S., Kim, S.-J., Lee, S. J., Park, C. H., Kim, B.-T., Song, G.-S., Moon, B.-S., & Ryu, S.-Y. (2019). Effects of Tegoprazan, a Novel Potassium-Competitive Acid Blocker, on Rat Models of Gastric Acid–Related Disease. The Journal of Pharmacology and Experimental Therapeutics, 369(3), 318–327. https://doi.org/10.1124/jpet.118.254904

Kongkam, P., Khongkha, W., Lopimpisuth, C., Chumsri, C., Kosarussawadee, P., Phutrakool, P., Khamsai, S., Sawanyawisuth, K., Sura, T., Phisalprapa, P., Buamahakul, T., Siwamogsatham, S., Angsusing, J., Poonniam, P., Wanaratna, K., Teerachaisakul, M., & Pongpirul, K. (2023). Curcumin and proton pump inhibitors for functional dyspepsia: A randomised, double blind controlled trial. BMJ Evidence-Based Medicine, 28(6), 400–407. https://doi.org/10.1136/bmjebm-2022-112231

Li, J., Wang, F., Lv, L., Xu, L., Zeng, E., & Tang, X. (2019). Histamine H2 antagonists for functional dyspepsia. Medicine, 98(47), e18128. https://doi.org/10.1097/MD.0000000000018128

Mahadeva, S., Yadav, H., Rampal, S., Everett, S. M., & Goh, K.-L. (2010). Ethnic variation, epidemiological factors and quality of life impairment associated with dyspepsia in urban Malaysia. Alimentary Pharmacology & Therapeutics, 31(10), 1141–1151. https://doi.org/10.1111/j.1365-2036.2010.04270.x

Mahadeva, S., Yadav, H., Everett, S. M., & Goh, K.-L. (2012). Economic Impact of Dyspepsia in Rural and Urban Malaysia: A Population-Based Study. Journal of Neurogastroenterology and Motility, 18(1), 43–57. https://doi.org/10.5056/jnm.2012.18.1.43

Mendoza, N.R.N.P., FPAFP, Espallardo, N.M., Anna Guia O. Limpoco, A. G. O., Lardizabal-Bunyi, J. F., Andal-Saniano, A. C., Elinore Alba-Concha, E., & Bautista, T. T. G. (2022). Clinical Pathway for the Management of Uninvestigated Dyspepsia among Adults in Family and Community Practice: Updated 2021. journal.pafp.org. (2022, March 8). https://thepafp.org/journal/abstract/clinical-pathway-for-the-management-of-uninvestigated-dyspepsia-among-adults-in-family-and-community-practice-updated-2021/

Moayyedi, P. M., Lacy, B. E., Andrews, C. N., Enns, R. A., Howden, C. W., & Vakil, N. (2017). ACG and CAG Clinical Guideline: Management of Dyspepsia. American Journal of Gastroenterology, 112(7), 988–1013. https://doi.org/10.1038/ajg.2017.154

Mukhtar, K., Nawaz, H., & Abid, S. (2019). Functional gastrointestinal disorders and gut-brain axis: What does the future hold? World Journal of Gastroenterology, 25(5), 552–566. https://doi.org/10.3748/wjg.v25.i5.552

Nikkhah Bodagh, M., Maleki, I., & Hekmatdoost, A. (2019). Ginger in gastrointestinal disorders: A systematic review of clinical trials. Food Science & Nutrition, 7(1), 96–108. https://doi.org/10.1002/fsn3.807

Nugent, C. C., Falkson, S. R., & Terrell, J. M. (2025). H2 Blockers. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK525994/

Perkumpulan Gastroenterologi Indonesia. (2021). Konsensus Nasional Penatalaksanaan Dispepsia dan Infeksi Helicobacter pylori di Indonesia (Revisi 2021). Perkumpulan Informasi dan Penerbitan Interna.

Puram, S., Suh, H. C., Kim, S. U., Bethapudi, B., Joseph, J. A., Agarwal, A., & Kudiganti, V. (2013). Effect of GutGard in the Management of Helicobacter pylori: A Randomized Double Blind Placebo Controlled Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2013, 263805. https://doi.org/10.1155/2013/263805

Ohtsu, T., Takagi, A., Uemura, N., Inoue, K., Sekino, H., Kawashima, A., Uchida, M., & Koga, Y. (2017). The Ameliorating Effect of Lactobacillus gasseri OLL2716 on Functional Dyspepsia in Helicobacter pylori-Uninfected Individuals: A Randomized Controlled Study. Digestion, 96(2), 92–102. https://doi.org/10.1159/000479000

Ranasinghe, P., Pigera, S., Premakumara, G. S., Galappaththy, P., Constantine, G. R., & Katulanda, P. (2013). Medicinal properties of ‘true’ cinnamon (Cinnamomum zeylanicum): A systematic review. BMC Complementary and Alternative Medicine, 13, 275. https://doi.org/10.1186/1472-6882-13-275

Raveendra, K. R., Jayachandra, null, Srinivasa, V., Sushma, K. R., Allan, J. J., Goudar, K. S., Shivaprasad, H. N., Venkateshwarlu, K., Geetharani, P., Sushma, G., & Agarwal, A. (2012). An Extract of Glycyrrhiza glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Evidence-Based Complementary and Alternative Medicine: eCAM, 2012, 216970. https://doi.org/10.1155/2012/216970

Shetty, A. J., Balaraju, G., Shetty, S., & Pai, C. G. (2017). Quality of Life in Dyspepsia and its Subgroups Using EQ-5D (EuroQol) Questionnaire. Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association, 23(2), 112–116. https://doi.org/10.4103/sjg.SJG_48716

Shrestha, D. B., Budhathoki, P., Subedi, P., Khadka, M., Karki, P., Sedhai, Y. R., Karki, B. R., Mir, W. A. Y., Shrestha, D. B., Budhathoki, P., Subedi, P., Khadka, M., Karki, P., Sedhai, Y. R., Karki, B. R., & Mir, W. A. Y. (2021). Acotiamide and Functional Dyspepsia: A Systematic Review and Meta-Analysis. Cureus, 13(12). https://doi.org/10.7759/cureus.20532

Singletary, K. W. (2022). Sesame: Potential Health Benefits. Nutrition Today, 57(5), 271. https://doi.org/10.1097/NT.0000000000000562

Syam, A. F., Simadibrata, M., Makmun, D., Abdullah, M., Fauzi, A., Renaldi, K., Maulahela, H., & Utari, A. P. (2017). National Consensus on Management of Dyspepsia and Helicobacter pylori Infection. Acta Medica Indonesiana, 49(3), 279. https://www.actamedindones.org/index.php/ijim/article/view/594

Syam, A. F., Miftahussurur, M., Makmun, D., Abdullah, M., Rani, A. A., Siregar, G. A., Simadibrata, M., Zubir, N., Dewa Nyoman Wibawa, I., Purnomo, H. D., Manan, C., Djojoningrat, D., Fauzi, A., Renaldi, K., Maulahela, H., Utari, A. P., Pribadi, R. R., Muzellina, V. N., Nursyirwan, S. A., … Yamaoka, Y. (2023). Management of dyspepsia and Helicobacter pylori infection: The 2022 Indonesian Consensus Report. Gut Pathogens, 15, 25. https://doi.org/10.1186/s13099-023-00551-2

Talley, N. J., & Ford, A. C. (2015). Functional Dyspepsia. The New England Journal of Medicine, 373(19), 1853–1863. https://doi.org/10.1056/NEJMra1501505

Talley, N. J. (2017). Functional Dyspepsia: Advances in Diagnosis and Therapy. Gut and Liver, 11(3), 349–357. https://doi.org/10.5009/gnl16055

Tziatzios, G., Gkolfakis, P., Leite, G., Mathur, R., Damoraki, G., Giamarellos-Bourboulis, E. J., & Triantafyllou, K. (2023). Probiotics in Functional Dyspepsia. Microorganisms, 11(2), 351. https://doi.org/10.3390/microorganisms11020351

Wauters, L., Slaets, H., Paepe, K. D., Ceulemans, M., Wetzels, S., Geboers, K., Toth, J., Thys, W., Dybajlo, R., Walgraeve, D., Biessen, E., Verbeke, K., Tack, J., Wiele, T. V. de, Hellings, N., & Vanuytsel, T. (2021). Efficacy and safety of spore-forming probiotics in the treatment of functional dyspepsia: A pilot randomised, double-blind, placebo-controlled trial. The Lancet Gastroenterology & Hepatology, 6(10), 784–792. https://doi.org/10.1016/S2468-1253(21)00226-0

Xiao, Y., Liu, Y., Yu, K., Ouyang, M., Luo, R., & Zhao, X. (2012). Chinese Herbal Medicine Liu Jun Zi Tang and Xiang Sha Liu Jun Zi Tang for Functional Dyspepsia: Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine : eCAM, 2012, 936459. https://doi.org/10.1155/2012/936459

Yongwatana, K., Harinwan, K., Chirapongsathorn, S., Opuchar, K., Sanpajit, T., Piyanirun, W., & Puttapitakpong, C. (2022). Curcuma longa Linn versus omeprazole in treatment of functional dyspepsia: A randomized, double-blind, placebo-controlled trial. Journal of Gastroenterology and Hepatology, 37(2), 335–341. https://doi.org/10.1111/jgh.15705

Zhang, J., Wu, H. M., Wang, X., Xie, J., Li, X., Ma, J., Wang, F., & Tang, X. (2020). Efficacy of prebiotics and probiotics for functional dyspepsia: A systematic review and meta-analysis. Medicine, 99(7), e19107. https://doi.org/10.1097/MD.0000000000019107

Zobeiri, M., Parvizi, F., Shahpiri, Z., Heydarpour, F., Pourfarzam, M., Memarzadeh, M. R., Rahimi, R., & Farzaei, M. H. (2021). Evaluation of the Effectiveness of Cinnamon Oil Soft Capsule in Patients with Functional Dyspepsia: A Randomized Double-Blind Placebo-Controlled Clinical Trial. Evidence-Based Complementary and Alternative Medicine: eCAM, 2021, 6634115.



DOI: https://doi.org/10.22146/farmaseutik.v22i1.105933

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