Functional dyspepsia - sensation of pain or discomfort (heaviness, overflow, early satiety) in the epigastric region without the presence of organic disease.
Types and Symptoms
Depending on the prevalence of various disorders recognize the variations of functional dyspepsia:
- yazvennopodobny (are major complaints of pain in the epigastric region);
- dyskinetic (dominated by gravity and a feeling of fullness in the epigastric region, nausea, early satiety);
- nonspecific (available complaints difficult unambiguously attributed to the first or second group).
Currently, functional dyspepsia, as well as Irritable bowel syndrome (Which combines functional dyspepsia in 50-70% of cases), it is considered as a biopsychosocial disease.
The causes of functional dyspepsia
Traumatic and stressful situations are detected in the vast number of patients with functional dyspepsia.
In normal gastric motility cause complaints in patients may be increased sensitivity of the stomach wall to stretch.
In some patients with functional dyspepsia (mainly yazvennopodobnom embodiment) important role in causing disorders may play increased secretion of hydrochloric acid.
Diagnostics
diagnostic algorithm funtsionalnost dyspepsia involves primarily the exclusion of organic diseases that occur with similar symptoms. Such diseases are often reflux esophagitis, Peptic ulcer disease, gastric cancer, gallstones, chronic pancreatitis, Endocrine disorders, scleroderma.
It is mandatory to apply:
- esophagogastroduodenoscopy;
- ultrasonography;
- clinical and biochemical blood tests;
- General analysis of feces;
- fecal occult blood;
- X-ray examination of the stomach;
- electrogastrography;
- manometry and scintigraphy of the stomach;
- daily monitoring intraesophageal acidity.
Treatment of functional dyspepsia
Smoking, alcohol, abuse of coffee cause dysmotility of the gastrointestinal tract and can provoke so exacerbation. Dietary measures (giving up bad habits, frequent small feedings with a reduction of saturated fats in the diet) contribute to the normalization of gastric motility and duodenal ulcers, and may reduce the severity of symptoms of functional dyspepsia.
When yazvennopodobnom functional dyspepsia embodiment the greatest effect is observed when using drugs suppressing the secretion of hydrochloric acid. These drugs can be successfully administered in "on demand" mode (that is, only if there are complaints).
In the treatment of patients with dyskinetic one main place is given destination prokinetics - preparations normalizing motility of the gastrointestinal tract. The medicines in this group include metoclopramide and domperidone. The use of metoclopramide (especially long-term) is now recognized as not quite desirable because the drug penetrates into the brain and causes a large number of patients (20-30%), serious side effects such as drowsiness, fatigue, concern. Domperidone is devoid of side effects of metoclopramide and is currently considered the drug of choice in the treatment of patients with functional dyspepsia.
New trends in the treatment of patients with PD are associated with the currently ongoing study of the efficacy of drugs such as k-receptor agonists (fedototsin) antagonists of 5-HT3 receptors (ondansetron) agonists, 5-HT4 receptors (tegaserod) receptor antagonists cholecystokinin A (loksiglumid) agonists, gonadotropin hormone (leuprolide), tricyclic antidepressants and selective inhibitors of reverse serotonin uptake.
This article is based on information of breast cancer - Independent publications practitioners
