Functional Dyspepsia - An Updated Review

Functional dyspepsia (FD) refers to upper abdominal symptoms like upper abdominal or retrosternal pain or discomfort; heart burn; nausea; etc. The symptoms are common; but often poorly understood and mistaken for conditions like chronic gastritis and peptic ulcer disease. Worldwide; the prevalence of dyspepsia is about 20-30 [1]. In the department of internal medicine at the Ruhengeri hospital; there have been 16.4 outpatient cases and 16.1 cases of admissions (Jan-June-2014). A high number of cases would be in other hospitals as well. The causes postulated are the increased production of acid; visceral hypersensitivity; H. pylori infection; emotional stress; reduced immunity; etc. The diagnosis is based on exclusion of organic causes for similar symptoms. The treatment is mainly with lifestyle modifications; and the pharmacological therapy consists of antacids; antiflatulents; prokinetic drugs; cytoprotective drugs; and proton pump inhibitors. It can be recommended that greater awareness needs to be generated among physicians regarding FD. They in turn can counsel patients and lay stress on lifestyle and preventive factors to improve this described condition

Who should be screened to reduce the endoscopy workload in Mulago Hospital?

A retrospective study of 330 patients who had been endoscoped in Mulago hospital was done. It was found that of these 119 (36.1) were normal endoscopically. Normal endoscopy was significantly associated with patients presenting with dyspepsia. Dyspepsia was common in the age group 13-45 years compared to the age group 46-85 years. The older age group; 46-85 years; had a singificantly higher prevalence of serious disease. It is concluded that it is the younger patients with dyspepsia who should be screened to reduce the endoscopy workload. Published guidelines should be used to assist in the screening process