Dyspepsia dr maduseno sp pd

Alimentary Pharmacology and Therapeutics, 1999

Journal of Gastroenterology and Hepatology, 1993

Journal of Enam Medical College

Ramathibodi Medical Journal, 2019

The majority of cases with dyspepsia usually have normal gastroscopic finding, so some unusual causes may be easily neglected under the umbrella of nonulcer dyspepsia as in this case. We report a 64-year-old Thai patient who suffered from dyspepsia and fatigue for many years. Her latest physical examination was unremarkable. Although she did not have any warning signs, many abdominal investigations including the ultrasonography, computerized tomography, barium enema with air contrast, esophagogastroduodenoscopy, and colonoscopy were repeatedly performed in different hospitals and all revealed unremarkable. The last esophagogastroduodenoscopy showed only mild acute gastritis that was not expected to account for the many-year dyspepsia and fatigue. The unusual and rare causes of long term dyspepsia were extensively investigated. Finally, she was found to have serum cortisol less than 0.8 , normal serum calcium, phosphorus, and electrolytes but minimally abnormal thyroid function test....

United European Gastroenterology Journal, 2021

BackgroundFunctional dyspepsia (FD) is one of the most common conditions in clinical practice. In spite of its prevalence, FD is associated with major uncertainties in terms of its definition, underlying pathophysiology, diagnosis, treatment, and prognosis.MethodsA Delphi consensus was initiated with 41 experts from 22 European countries who conducted a literature summary and voting process on 87 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 36 statements.ResultsThe panel agreed with the definition in terms of its cardinal symptoms (early satiation, postprandial fullness, epigastric pain, and epigastric burning), its subdivision into epigastric pain syndrome and postprandial distress syndrome, and the presence of accessory symptoms (upper abdominal bloating, nausea, belching), and overlapping conditions. Also, well accepted are the ...

Gut, 1987

This study aims to determine whether the features of dyspepsia can discriminate a subgroup of patients who present with non-ulcer dyspepsia from other diagnostic categories. The following groups were studied (1) One hundred and thirteen patients with endoscopically confirmed non-ulcer dyspepsia in the absence of clinical, biochemical or radiological evidence of other gastrointestinal diseases or disorders, termed essential dyspepsia; (2) Fifty five patients with symptomatic and endoscopically proven peptic ulceration (32 duodenal ulcers, 23 gastric ulcers); (3) Fifty three patients admitted to hospital with biliary pain and cholelithiasis without other lesion at laparotomy. All patients completed a structured history questionnaire at personal interview. Stepwise logistic regression analysis was done on 19 predefined variables to determine if one or more of these could discriminate between the diagnostic categories. The results suggest that certain groups of symptoms may be of diagnostic value, but many are not. Upper abdominal pain aggravated by food or milk, pain severity, night pain, vomiting, weight loss, and age significantly discriminated essential dyspepsia from the other diagnostic categories. A scoring system was established based on these discriminating symptoms. Using the weighted score, at a sensitivity of 57%, the specificity for a diagnosis of essential dyspepsia was 94%, but only prospective studies will determine if this scoring system is of actual clinical value. Dyspepsia is an extremely common symptom with a prevalence in the community of approximately 30%.1 In 1905 Lord Moynihan declared that most cases of dyspepsia could be diagnosed by the symptoms alone.2 Recent studies have suggested, however, that patients who present with dyspepsia are often misdiagnosed.3 This may be because of the failure of doctors to elicit and analyse symptoms accurately, perhaps because of a faulty mental 'database' regarding the diagnostic value of dyspep- tiC symptoms.-5 Horrocks and de Dombal in a computer-aided study found that the manifestations of disease in patients with peptic ulceration and functional dyspepsia differed in several respects from the typical picture described in textbooks5

The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi, 2010

This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvesti...

European Journal of Surgery, 2003

To find out if various diagnostic criteria could distinguish organic from non-organic causes of dyspepsia. Subjects: 635 patients previously interviewed by computer questionnaire. Interventions: Upper gastrointestinal endoscopy, laboratory tests, clinical examination. Main outcome measure: Differentiation between organic and functional dyspepsia. Results: 106 patients had functional dyspepsia. Of these 83 had ulcer-like dyspepsia, 76 motility-like dyspepsia, and 50 refluxlike dyspepsia. Eight patients had unspecified dyspepsia. Conclusions: There was a considerable overlap between different subgroups, and the criteria did not differentiate between organic and non-organic causes of dyspepsia though the symptom criteria in most cases showed an independent value in discriminating between different subgroups. The clinical usefulness of the criteria remains to be shown.

Gut, 1991

A prospective multifactorial study of symptoms and disturbance of gastrointestinal function has been undertaken in 50 patients with non-ulcer dyspepsia. Objective tests including solid meal gastric emptying studies, gastric acid secretion, E-HIDA scintiscan for enterogastric bile reflux, and hydrogen breath studies were carried out in all patients and validated against control data. Gastroscopy and biopsy were carried out in non-ulcer dyspepsia patients only. Non-ulcer dyspepsia patients were categorised on the basis of predominant symptoms as: dysmotility-like dyspepsia (n=22); essential dyspepsia (n= 14), gastro-oesophageal reflux-like dyspepsia (n= 11); and ulcer-like dyspepsia (n=3). In the total non-ulcer dyspepsia population, solid meal gastric emptying was delayed (T50 mean (SEM)= 102 (6) minutes (patients) v 64 (6) minutes (controls), (p<0.01)) and high incidences ofgastritis (n= 26) and Helicobacter pyloridis infection (n= 18) were found. An

Digestive Diseases and Sciences, 1995

Patients with duodenal ulcer or functional dyspepsia do not differ on dyspeptic symptoms. The aim of the present study was to test the hypothesis that functional dyspepsia and duodenal ulcer are two different diagnostic entities by examining the discriminating power of several anamnestic, biological, and psychosocial variables. Ninety-four patients with duodenal ulcer and 86 patients with functional dyspepsia were included. Anamnestic data, global assessment, Helicobacter pylori status, blood group, Lewisa+ phenotype, and several measures of psychological distress and somatic complaints were registered. Compared to patients with functional dyspepsia, the duodenal ulcer patients were more often infected by Helicobacter pylori and had their stomach discomfort more often relieved by eating. Compared to patients with duodenal ulcer, patients with functional dyspepsia had higher scores of depression, trait anxiety, general psychopathology and different somatic complaints (called somatization). They were also less satisfied with the health care system, their disorder had a greater negative impact on their quality of life, and their global assessment of own health was poorer. Discriminant analysis including age, smoking, Helicobacter pylori status, global assessment, and somatic complaint classified 86.1% of the patients correctly (77.9% of the patients with functional dyspepsia and 93.6% of the patients with duodenal ulcer). It is concluded that duodenal ulcer and functional dyspepsia are two separate diagnostic entities. Patients with duodenal ulcer are older, smoke more often, and almost all are infected with Helicobacter pylori, while patients with functional dyspepsia are characterized by somatization and a negative assessment of their own health.