Dyspepsia is most optimally defined as pain or discomfort centred in the upper abdomen.
The symptom complex may be caused by peptic ulcer disease, gastro-oesophageal reflux, or gastric cancer but is most often due to functional (or non-ulcer) dyspepsia.
While upper endoscopy is the method of choice to determine the underlying cause of dyspepsia, it is expensive.
A more pragmatic approach is needed in the Asia-Pacific region where health services are limited.
A detailed treatment algorithm is given for managing patients presenting with new-onset dyspepsia and documented functional dyspepsia after endoscopy, and evidence to support this approach is reviewed.
Prompt endoscopy is recommended for patients with alarm fea-tures.
In patients without alarm features, treatment for 2-4 weeks with an empirical anti-secretory or prokinetic agent, followed by investigation using non-invasive Helicobacter pylori testing and treatment for patients who do not respond or relapse, is recommended.
Trials of management strategies are now needed to establish the efficacy and cost-effectiveness of the approaches recommended.
Mots-clés Pascal : Dyspepsie, Stratégie, Etiopathogénie, Laparoscopie, Diagnostic, Traitement, Asie, Océan Pacifique, Homme, Article synthèse, Appareil digestif pathologie, Endoscopie
Mots-clés Pascal anglais : Dyspepsia, Strategy, Etiopathogenesis, Laparoscopy, Diagnosis, Treatment, Asia, Pacific Ocean, Human, Review, Digestive diseases, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0280661
Code Inist : 002B02H. Création : 27/11/1998.