{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T11:01:16Z","timestamp":1763636476764,"version":"3.45.0"},"reference-count":40,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: This multicenter retrospective study evaluated the long-term outcomes of functional dyspepsia (FD) and factors associated with treatment resistance over a 3-year period after treatment initiation. Methods: A total of 111 patients diagnosed with FD according to the Rome IV criteria and confirmed by upper endoscopy to have no organic disease were retrospectively analyzed. First-line therapy included acid-suppressive drugs, prokinetics, and the Kampo medicine rikkunshito, whereas second-line therapy comprised anxiolytics or antidepressants for refractory cases. Gastrointestinal symptoms, psychological distress, and health-related quality of life were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), Hospital Anxiety and Depression Scale (HADS), and Short Form-8. Symptom improvement was evaluated at 1 and 3 years. Results: The improvement rates at 1 and 3 years were 50.5% and 80.2%, respectively. At baseline, the non-improvement group had significantly higher HADS-Depression and GSRS-Abdominal Pain scores (p &lt; 0.05). Multivariate analysis identified HADS-Depression (odds ratio [OR] = 0.676, p = 0.019) and GSRS-Abdominal Pain (OR = 0.461, p = 0.038) as independent predictors of treatment resistance. Conclusions: The present findings indicate that FD often requires prolonged therapy, and baseline depressive symptoms and abdominal pain predict poor long-term outcomes, emphasizing the need for early psychological assessment and integrated management.<\/jats:p>","DOI":"10.3390\/jcm14228224","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T10:30:59Z","timestamp":1763634659000},"page":"8224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes After Therapeutic Induction in Patients with Functional Dyspepsia"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5480-1207","authenticated-orcid":false,"given":"Takayuki","family":"Kitano","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-9009","authenticated-orcid":false,"given":"Toshihiko","family":"Tomita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Mieno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroo","family":"Sei","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-9047","authenticated-orcid":false,"given":"Hirotsugu","family":"Eda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8307-2445","authenticated-orcid":false,"given":"Toshiyuki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikio","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6293-566X","authenticated-orcid":false,"given":"Takuya","family":"Okugawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirokazu","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9844-642X","authenticated-orcid":false,"given":"Hiroto","family":"Miwa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7051-618X","authenticated-orcid":false,"given":"Shinichiro","family":"Shinzaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional gastrointestinal disorders: History, pathophysiology, clinical features and Rome IV","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1038\/ajg.2017.154","article-title":"ACG and CAG Clinical Guideline: Management of Dyspepsia","volume":"112","author":"Moayyedi","year":"2017","journal-title":"Am. 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