MANAGEMENT OF FUNCTIONAL DYSPEPSIA IN ACCORDANCE WITH MODERN GUIDELINES AND RECOMMENDATIONS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11299Keywords:
functional dyspepsia, gastritis, Helicobacter pylori, guidelines, family doctorAbstract
Dyspepsia is a common reason for seeking medical health care and significantly decreases the quality of life, reduces the efficiency of patients, requires significant economic resources. Most of these patients are addressed for the health care to a family doctor.
The aim – to analyze new guidelines and recommendations, forming a modern algorithm for diagnostic and treatment of functional dyspepsia in the primary health care.
Material and Methods. The study used informational, bibliographic and analytical methods in international electronic databases.
Results. The “uninvestigated dyspepsia” term is the most common case of seeking medical help, if previous examinations have not been done. Some investigations tests have to be prescribed to diagnose functional dyspepsia and to exclude the organic pathology. Dyspepsia is a clinical diagnosis, while chronic gastritis is a morphological diagnosis. According to the modern guidelines, indications’ determination for the upper endoscopic examination and diagnostic Helicobacter pylori is the family doctor’s task. At uninvestigated dyspepsia “test and treat” tactics for Helicobacter pylori infection gives a positive clinical benefit, especially in the long term. Also, it repairs the gastric mucosa and has a cancer preventive effect. PPI has proven effectiveness in the treatment of all functional dyspepsia types, and has to be prescribed for 4–8 weeks, with further reception if needed. Modern prokinetics, tricyclic antidepressants, psychological therapy are recommended to be prescribed in the cases of no effect from first-line therapy of PPI. If it is impossible to achieve a positive effect of functional dyspepsia treatment, acupuncture, phytotherapy, probiotics and vitamin complexes treatment methods can be used, but they do not have a sufficient evidence base.
Conclusions. Indications’ determination for upper endoscopic examination and Helicobacter pylori diagnostics is the family doctor’s task, and in case of a positive result – eradication of Helicobacter pylori. PPIs, prokinetics, tricyclic antidepressants, and psychological therapy have proven benefits in the treatment of functional dyspepsia.
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