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Functional dyspepsia
Author：Dr.Liu Haixia
Functional dyspepsia is one of the most common non-organic gastrointestinal diseases, accounting for 40% ~ 50% of the outpatients in gastroenterology department. Functional dyspepsia is mainly manifested as a sense of satiety soon after eating, upper abdominal distention after eating, belchingand acid reflux. Some patients may have anxiety and depression.
For patients with dyspepsia symptoms, his or her age equal or above 40 , or accompanied by the following warning signs such asobvious weight loss, anemia, hematemesis, tarry stool, difficult or painful swallowing, abdominal mass, family history of gastric cancer, etal, should timely take relevant examination, such as gastroscopy, abdominal ultrasonography, computed tomography (CT), blood counts, stool test, blood chemistry and so on, in order to make clear the underlying causes.
The clinical diagnosis of functional dyspepsia is based on the following points:
1. Early satiety after meals, abdominal distension, epigastric pain, upper abdominal burning and other clinical symptoms.
2. No evidence of organic disease to explain the above symptoms, including gastroscopy.
3. The symptoms have been present for at least 6 months before diagnosis, and the above diagnostic criteria have been met in the last 3 months.
The pathogenesis of functional dyspepsia is not fully understood, which may be the result of a combination of many factors, including gastric motility disorder, increased visceral sensitivity, decreased gastric fundus receptive diastolic function to food, changes in intestinal flora, and psychosocial factors. Risk factors for the occurrence of functional dyspepsia include acute gastroenteritis, female, smoking, use of non-steroidal anti-inflammatory drugs, Helicobacter pylori infection, anxiety, depression and psychosocial factors, at al.
Clinical drug treatment of functional dyspepsia mainly includes:
1.Helicobacter pylori eradication therapy: In patients with functional dyspeptic disease, the detection rate of Helicobacter pylori is 65% ~ 75%.Some patients' symptoms are obviously improved after eradication of Helicobacter pylori.
2. Proton pump inhibitors(PMIs) : such as omeprazole, rabeprazole and nexium. At present, PMIs are widely used in the treatment of functional dyspepsia. They are suitable for the symptoms of abdominal pain and burning feeling.
3. Gastrointestinal prokinetics: such as Mosapride. Gastric prokinetics can significantly improve meal-related epigastric symptoms, such as upper abdominal fullness, early satiety, etal.
4. Anxiety and depression drugs: Tricyclic antidepressants can be used for patients who fail to respond to acid suppressive agents and prokinetics and are accompanied by obvious mental disorders.
Drug treatment should be carried out under the guidance of doctors, and attention should be paid to the adverse reactions of drugs during medication.
Patients with functional dyspepsia should also take reasonable diets, avoid tobacco, wine, irritant or indigestible food, avoid the application of drugs that have damage to the gastric mucosa, ensure adequate sleep, take part in moderate physical exercise, reduce mental pressure, and maintain a relaxed mood.
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