Lacy Brian E, Cash Brooks D
Division of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
JAMA. 2008 Feb 6;299(5):555-65. doi: 10.1001/jama.2007.51-a. Epub 2008 Jan 1.
Functional dyspepsia is a highly prevalent disorder that accounts for 5% of visits to primary care clinicians. It frequently coexists with other gastrointestinal tract disorders, including irritable bowel syndrome and gastroesophageal reflux disease. Symptoms of functional dyspepsia, including epigastric pain, early satiety, and postprandial nausea, are nonspecific, making its diagnosis difficult. Functional dyspepsia is a heterogeneous disorder involving a number of different pathophysiologic processes, culminating in both gastrointestinal sensory and motor dysfunction. Although functional dyspepsia does not impart any increased risks to long-term health, it significantly affects both individuals and society. The economic burden of evaluating and treating functional dyspepsia is estimated to be at least $1 billion per year, and patients with functional dyspepsia experience a markedly reduced quality of life. Using the case of Ms C, we apply an evidence-based approach to highlight current knowledge in the diagnosis, evaluation, and treatment of functional dyspepsia.
功能性消化不良是一种高度常见的疾病,占初级保健医生门诊量的5%。它常与其他胃肠道疾病并存,包括肠易激综合征和胃食管反流病。功能性消化不良的症状,包括上腹部疼痛、早饱感和餐后恶心,都不具有特异性,这使得其诊断较为困难。功能性消化不良是一种异质性疾病,涉及多种不同的病理生理过程,最终导致胃肠道感觉和运动功能障碍。虽然功能性消化不良不会增加长期健康风险,但它对个人和社会都有显著影响。评估和治疗功能性消化不良的经济负担估计每年至少10亿美元,功能性消化不良患者的生活质量明显下降。我们以C女士的病例为例,采用循证医学方法来突出当前关于功能性消化不良诊断、评估和治疗的知识。