Proposal for Slovenian recommendations for the treatment of patients with dyspepsia
Abstract
Abstract: Dyspepsia is defined as chronic or recurrent pain or discomfort in the upper abdomen. Other possible symptoms are early satiety, upper abdominal fullness, bloathing, belching or nausea. The prevalence of dyspepsia is between 15% and 25%. Every forth patient seeks medical consultation. After diagnostic examinations (consultation, upper gastrointestinal endoscopy) dyspeptic patients can be separated in a group of organic dyspepsia (duodenal or gastric ulcer, gastroesophageal reflux disease, cancer), that represent 40% to 61% of patients, and in a group of functional dyspepsia. Dyspepsia accounts for more than 40% of upper gastrointestinal endoscopies performed in a year in USA. Because of cost-benefit reasons several management options for patients younger than 45 years without alarm features have been set up. When prevalence of Helicobacter pylori is more than 12% test and treat is the preferred option. When Helicobacter pylori prevalence is less than 12% empiric antisecretary therapy is recommended. In this article proposal for recommendations for the treatment of dyspepsia based on evidence based medicine are described. Indications for prompt endoscopy are clarified. For patients younger than 45 years without features of alarm symptoms, test and treat Helicobacter pylori is the preferred option.
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