ABSTRACT
Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with 'test and treat' of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD.
Subject(s)
Humans , Antacids/therapeutic use , Anti-Ulcer Agents/therapeutic use , Antidepressive Agents/therapeutic use , Dyspepsia/diet therapy , Gastroscopy , Helicobacter Infections/drug therapy , Helicobacter pylori , Histamine H2 Antagonists/therapeutic use , Proton Pump Inhibitors/therapeutic use , Psychotherapy , Serotonin 5-HT3 Receptor Antagonists/therapeutic use , Vasoconstrictor Agents/therapeutic useABSTRACT
Non ulcer dyspepsia is defined as the presence of pain and/or discomfort localized to the upper abdomen, episodic or persistent, with a duration superior of 4 weeks, in the absecence of any organic lesion or sistemic disease. In order to facilitate its management, non ulcer dyspepsia is classified in five typres: 1) gastroesophageal reflux disease; 2) ulcer-like disease; 3) motility disorders; 4) aerophagia; 5) diopatic. The main clinic and pathophysiologic characteristics of each type are discussed. The diagnosis is basead in the clinical picture and in the negative results of some exams (endoscopy, ultrasound) and sugestive results of others (manometry, contrast X-ray, 24 hour pHmetry and gastric emptying time). The treatment may be divided in general (diet, behaviour, phychologic measures) and pharmacological approach (antiacids, H2blockers, procinetic agents). Each case should be individualized in terms of the presence of its main symptoms. Emphasis is put on the psychologic features and their adequate approach by the physician