Second Asian Consensus Report on Functional Dyspepsia (2025): Updated Recommendations

Background: Functional dyspepsia (FD) is a common gastrointestinal disorder that significantly impacts patients' quality of life. Over a decade ago, the Asian Neurogastroenterology and Motility Association (ANMA) and the Asian Pacific Association of Gastroenterology (APAGE) jointly developed the first Asian consensus report on FD. In this consensus report, members of ANMA and APAGE provide updated recommendations on the definition, diagnosis, epidemiology, pathophysiology, and management of FD, focusing on Asian populations. Methods: The task force members conducted a systematic literature review and used a modified Delphi process to develop updated consensus statements. Based on members' feedback, statements that failed to reach at least 80% consensus in the first round of voting were revised. Revisions included rephrasing for clarity, incorporating additional evidence, and subgroup voting during a second round of discussion at a hybrid meeting. Results: The task force developed 32 statements covering key aspects of FD. Major updates include new insights into the pathophysiology and emerging treatment options. The task force acknowledged that the limited scope and heterogeneity of available studies limit definitive conclusions about the utility of some emerging therapies such as probiotics and potassium-competitive acid blockers in FD management. Conclusions: The second Asian Consensus Report on FD provides updated evidence-based recommendations to improve the diagnosis and management of FD in clinical practice, particularly in the Asian setting.