Evaluation and management of dyspepsia - current perspective
- Author:
KL Goh
- Publication Type:Review
- From:Malaysian Family Physician
2007;2(1):2-7
- CountryMalaysia
- Language:English
-
Abstract:
Key points
o Spend time taking a good history and performing a physical examination even though the majority of patients have “functional” symptoms. Exclude “non-dyspepsia” conditions and be careful in excluding a “surgical” abdomen.
o Consider gastroscopy or an ultrasound or CT scan of the abdomen, if alarm symptoms are present. The threshold
to investigate should be lower with older male patients as there is a higher chance of organic disease.
o When patients’ symptoms are unclear, a close follow-up and review is useful. Symptoms persisting over many
months or years are unlikely to have an organic basis.
o Explore, understand and address patients’ concerns including psychological problems. Patients need to be reassured.
o Sensible advice on food/meal and lifestyle modifications is useful. Antacids often give immediate relief to acute
dyspeptic symptoms. Gastroesophageal reflux symptoms may be atypical − a trial of PPI therapy may be useful.
Patients with wind, bloating and discomfort often benefit from a course of prokinetic agents.
- Full text:W020151007333412456246.pdf
