Buljevac Mladen, Banić Marko, Kujundzić Milan, Dominis Mara, Colić-Cvrlje Vesna, Kardum Dusko, Katicić Miroslava
Klinika za unutarnje bolesti, Klinicka bolnica Dubrava, Zagreb.
Lijec Vjesn. 2002 Sep;124 Suppl 1:61-3.
In this article we reviewed experiences in approach and procedure with dyspepsia, with special accent on non-ulcer dyspepsia and Helicobacter pylori infection. Dyspepsia makes around 50% of gastroenterology cases. In 20% of cases it is caused by peptic ulcer disease and in 50% of cases non-ulcer dyspepsia. Around 50% of non-ulcer dyspepsia is followed by coexistent Helicobacter pylori positive gastritis. Dyspepsia followed by alarming symptoms in patients who are over 55 years old or in patients who are using NSAID indicated urgent endoscopic procedure--gastroscopy. In other patients non-invasive testing on Helicobacter pylori infection is recommended where eradication therapy should be applied in Helicobacter pylori positive and empirical cure by antisecreting drugs or prokinetics in Helicobacter pylori negative patients. Final gastroscopic evaluation is indicated after unsuccessful therapy. Ceasing of non-ulcer dyspeptic symptoms could be predicted in 20% of patients with cured Helicobacter pylori infection.
在本文中,我们回顾了消化不良的诊断方法和治疗经验,特别强调了非溃疡性消化不良和幽门螺杆菌感染。消化不良约占胃肠病学病例的50%。其中20%的病例由消化性溃疡病引起,50%的病例为非溃疡性消化不良。约50%的非溃疡性消化不良伴有幽门螺杆菌阳性胃炎。55岁以上或正在使用非甾体抗炎药(NSAID)且有报警症状的消化不良患者,需进行紧急内镜检查——胃镜检查。其他患者建议进行幽门螺杆菌感染的非侵入性检测,幽门螺杆菌阳性患者应采用根除治疗,幽门螺杆菌阴性患者则采用抗分泌药物或促动力药进行经验性治疗。治疗失败后需进行最终的胃镜评估。20%幽门螺杆菌感染治愈的患者非溃疡性消化不良症状可能会消失。