STOMACH AND DUODENUM: Edited by Tilak U. ShahUpdates in functional dyspepsia and bloatingLacy, Brian E.; Cangemi, David J. Author Information Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida, USA Correspondence to Brian E. Lacy, PhD, MD, Mayo Clinic, Division of Gastroenterology & Hepatology, Davis Building, 6th Floor, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Tel: +1 904 953 6319; fax: +1 904 953 7366; e-mail: [email protected] Current Opinion in Gastroenterology 38(6):p 613-619, November 2022. | DOI: 10.1097/MOG.0000000000000882 Buy Metrics Abstract Purpose of review Functional dyspepsia and bloating are common gastrointestinal conditions that frequently lead to gastroenterology referral. Both disorders have a significant negative impact on patients’ quality of life and the healthcare system. The purpose of this review is to highlight important new findings in the cause, pathophysiology and treatment of these two disorders. Recent findings Confocal laser endomicroscopy identified changes in epithelial barrier structure and function, providing important insights into the development of functional dyspepsia symptoms when combined with new observations of localized duodenal inflammation. Changes in the gut microbiome may be responsible for functional dyspepsia symptoms in some patients and may respond to gut-selective antibiotics. New data from the NIH-sponsored Gastroparesis Consortium confirmed that functional dyspepsia and gastroparesis are not distinct disorders but rather exist on a spectrum. Virtual reality may be a new therapeutic option for the treatment of functional dyspepsia. A novel questionnaire was developed and validated to assess symptoms, prevalence and impact in patients with bloating and distension. A meta-analysis identified medications to treat symptoms of bloating in patients with irritable bowel syndrome and constipation. Summary Advances in our understanding of the pathophysiology of functional dyspepsia and bloating are leading to important changes in medical therapies. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.