Are psychological interventions effective in treating functional dyspepsia: a systematic review and meta-analysis.

Rodrigues, David M; Motomura, Douglas I; Tripp, Dean A; Beyak, Michael J

BACKGROUND Functional dyspepsia (FD) is a common gastrointestinal disorder, characterized primarily by post-prandial fullness or early satiety and/or pain in the epigastrium with no endoscopic evidence of disease. Psychological therapies have been adapted to the treatment of disordered gut-brain interaction such as FD. OBJECTIVES We sought to determine if psychological interventions were efficacious in providing symptom management and improving health-related quality of life in patients suffering from FD. METHODS Data were sorted that belonged to Embase (1947-January 2020), PsychINFO (1806 - January 2020) and Ovid MEDLINE (1946-January 2020). Randomized controlled trials using a psychological intervention in adults meeting relevant diagnostic criteria for functional dyspepsia were included. Data including symptom scores and quality of life measures were extracted. A random-effect model meta-analysis with standardized mean differences was used. RESULTS Nine randomized controlled trials were identified that met our inclusion criteria. These were small, single-centered studies and used varying psychological therapies. Three studies had a sham treatment arm, leading to a high risk of bias in the remaining studies. All the studies reported beneficial effects of psychological treatment on patient's symptoms, some of which persisted up to one year. Psychological intervention was associated with an improvement in global FD symptom scores (SMD -1.33, 95% CI -1.97 to -0.68). CONCLUSIONS Despite the limited data, the available evidence suggests that psychological therapy is beneficial in treating patients with FD and should be considered by treating physicians if available and patients are willing. Large well-designed, sham controlled trials are needed for this extremely common disorder.