Etiology of Dyspepsia: Implication for Empiric Therapy

Abstract

Dyspepsia describes a symptom complex thought to arise in the upper gastrointestinal tract and includes, in addition to epigastric pain or discomfort, symptoms such as heartburn, acid regurgitation, excessive burping or belching, a feeling of slow digestion, early satiety, nausea and bloating. Based on the evidence that heartburn cannot be reliably distinguished from other dyspeptic symptoms, the Rome definition appears to be too narrow and restrictive. It is particularly ill suited to the management of uninvestigated dyspepsia at the level of primary care. In patients presenting with uninvestigated dyspepsia, a symptom benefit is associated with a 'test and treat' approach for Helicobacter pylori infection. A substantial proportion of those who do not benefit prove to have esophagitis on endoscopy. In those with functional dyspepsia, the benefits of H pylori eradication, if any, appear to be modest. Hence, a 'symptom and treat' acid-suppression trial with proton pump inhibitors, and a 'test and treat' strategy for H pylori are two acceptable empirical therapies for patients with univestigated dyspepsia.

Comprehension and awareness of symptoms in women with dyspepsia

“…Hunt et al have suggested that patients with associated heartburn should be treated with proton-pump inhibitors (PPIs), which would relieve the patients' symptoms if they were suffering from GERD rather than dyspepsia. 17 If PPIs had no effect, this may suggest that the patients' upper abdominal symptoms were due to dyspepsia rather than GERD. This would, however, eliminate patients with dyspepsia, who may respond to acid inhibition.…”

Effects of the Brazilian phytopharmaceutical product Ierobina® on lipid metabolism and intestinal tonus

“…Dyspepsia is a condition comprising a complex of symptoms in the upper gastrointestinal tract which includes, in addition to epigastric pain or discomfort, symptoms, such as heartburn, acid regurgitation, excessive burping or belching, a feeling of slow digestion, early satiety, nausea and bloating (Talley et al, 1992;Hunt et al, 2002).…”

The number of Helicobacter pylori CagA EPIYA C tyrosine phosphorylation motifs influences the pattern of gastritis and the development of gastric carcinoma

“…16 In conclusion, we have shown that the magnitude of risk for gastric carcinoma and for gastric precancerous lesions increases with increasing number of EPIYA C motifs in the infecting H. pylori strains. Although the extent to which H. pylori eradication decreases the risk of gastric carcinoma is unknown and is still a controversial issue, 39,40 individuals infected with strains with higher-risk genotypes are most likely to benefit from H. pylori eradication, as such treatment could result in substantially reduced gastric carcinoma risk. Our results suggest that an intervention aimed at the 29% of individuals with gastritis and with the high-risk bacterial genotypes (i.e.…”