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    Dyspepsia

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    Bo Choi
    Dyspepsia is chronic or recurrent pain or discomfort centered in the upper abdomen, accompanied by symptoms like bloating, belching, nausea or heartburn. It can be caused by medications, H. pylori infection, or non-ulcer dyspepsia. Management options include testing and treating for H. pylori, empirical acid suppression therapy, or early endoscopy. Treatment involves antacids, H2 receptor antagonists, prostaglandins, or proton pump inhibitors, with proton pump inhibitors being the preferred option for acid suppression.

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    Dyspepsia

    Uploaded by

    Bo Choi
    111 views15 pages
    Dyspepsia is chronic or recurrent pain or discomfort centered in the upper abdomen, accompanied by symptoms like bloating, belching, nausea or heartburn. It can be caused by medications, H. pylori infection, or non-ulcer dyspepsia. Management options include testing and treating for H. pylori, empirical acid suppression therapy, or early endoscopy. Treatment involves antacids, H2 receptor antagonists, prostaglandins, or proton pump inhibitors, with proton pump inhibitors being the preferred option for acid suppression.

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    Dyspepsia is chronic or recurrent pain or discomfort centered in the upper abdomen, accompanied by symptoms like bloating, belching, nausea or heartburn. It can be caused by medications, H. pylori infection, or non-ulcer dyspepsia. Management options include testing and treating for H. pylori, empirical acid suppression therapy, or early endoscopy. Treatment involves antacids, H2 receptor antagonists, prostaglandins, or proton pump inhibitors, with proton pump inhibitors being the preferred option for acid suppression.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    111 views15 pages

    Dyspepsia

    Uploaded by

    Bo Choi
    Dyspepsia is chronic or recurrent pain or discomfort centered in the upper abdomen, accompanied by symptoms like bloating, belching, nausea or heartburn. It can be caused by medications, H. pylori infection, or non-ulcer dyspepsia. Management options include testing and treating for H. pylori, empirical acid suppression therapy, or early endoscopy. Treatment involves antacids, H2 receptor antagonists, prostaglandins, or proton pump inhibitors, with proton pump inhibitors being the preferred option for acid suppression.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    Dyspepsia

    Isaga, Pacelen T.

    Dyspepsia chronic or recurrent pain or discomfort centered in the upper abdomen Discomfort includes mild pain, upper abdominal fullness and feeling full earlier than expected with eating

    Dyspepsia
    =accompanied by bloating, belching, nausea or heartburn =may be called indigestion

    Classification
    Dyspepsia has been proposed to have symptomatic subgroups: ulcerlike - "Pain centered in the upper abdomen is the predominant (most bothersome) symptom. dysmotilitylike - "An unpleasant or troublesome nonpainful sensation (discomfort) centered in the upper abdomen is the predominant symptom; this sensation may be characterized by or associated with upper abdominal fullness, early satiety, bloating, or nausea." refluxlike-heart burn and acid regurgitation nonspecific

    Cause/etiology
    Some cases are caused by medications calcium antagonists, nitrates, theophyllines, bisphosphonates, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) Several studies provide prevalences of underlying causes based on findings at esophagogastroduodenoscopy (EGD)

    Non-ulcer dyspepsia (NUD)


    Rome criteria Nonulcer dyspepsia exists (functional dyspepsia) when EGD and other tests have excluded other diseases and the patient has the following Rome II criteria: At least 12 weeks, which need not be consecutive, within the preceding 12 months of:

    Non-ulcer dyspepsia (NUD)


    Persistent or recurrent dyspepsia (pain or discomfort centered in the upper abdomen); and No evidence of organic disease (including at upper endoscopy) that is likely to explain the symptoms; and No evidence that dyspepsia is exclusively relieved by defecation or associated with the onset of a change in stool frequency or stool form

    Management Options for New-Onset Dyspepsia


    The main strategies for managing new-onset dyspepsia are (1)empirical H2-receptor antagonist therapy, (2)empirical proton pump inhibitor (PPI) therapy, (3) H. pylori testing and treatment of positive cases (H pylori testand treat) followed by acid suppression if the patient remains symptomatic, (4) early endoscopy alone (5) early endoscopy with biopsy for H pylori and treatment if positive, (6) acid suppression followed by endoscopy and biopsy if the patient remains symptomatic, or (7) H pylori test and treat with endoscopy if the patient remains symptomatic

    Management Recommendations
    Patients 55 years of age or younger without alarm features =should receive H pylori test and treat followed by acid suppression if symptoms remain =H pylori testing is optimally performed by a C-urea breath test or stool antigen test =PPIs are the drug class of choice for acid suppression

    Patients 55 years of age or younger without alarm features


    Those who are H pylori negative =should be prescribed an empirical trial of acid suppression with a PPI for 48 weeks.

    Patients older than 55 years of age and for younger patients with alarm features (ex, weight loss, progressive dysphagia, recurrent vomiting, evidence of gastrointestinal bleeding, or family history of cancer) presenting with new-onset dyspepsia =Biopsy specimens should be obtained for H pylori at the time of endoscopy and eradication therapy offered to those who are infected because this may reduce the risk of subsequent peptic ulcer disease and gastric malignancy

    Treatment
    Antacids and alginates =relieve and prevent symptoms of dyspepsia =effectively reduce acid but evidence of healing effect has not been demonstrated

    H. pylori infection =One week triple therapy regimens including PPI, amoxicillin, and either clarithromycin or metronidazole to eradicate H.pylori in 90% of cases. =ranitidine bismuth citrate (H2 Receptor Antagonist) sometimes used instead of PPI

    H2 Receptor Antagonist =reduces gastric acid output promoting ulcer healing and relieving gastro esophageal reflux symptoms Prostaglandin analogues =reduces acid secretion and protects the gastric and duodenal linings, and promoting ulcer healing

    Proton pump inhibitor =treat gastric and duodenal ulcers, GERD, and esophagitis and to prevent and treat NSAID associated ulcers and are used together with antibacterials to eradicate H. pylori

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