Dispepsia näo-ulcerosa / Non ulcer dyspepsia

RESUMO

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