Richter J E
Division of Gastroenterology, University of Alabama, Birmingham 35294.
Scand J Gastroenterol Suppl. 1991;182:11-6. doi: 10.3109/00365529109109531.
Diseases presenting with dyspepsia fall into two general categories: organic and functional. Overall, most patients with dyspepsia have no underlying identifiable disease process. The diagnostic yield of organic causes is less in younger patients, and, conversely, serious organic lesions are common in elderly dyspeptic patients. The commonest organic causes of dyspepsia are peptic ulcer disease, gastroesophageal reflux, biliary tract disease, and gastric cancer. Symptoms and physical signs may help to differentiate these organic causes from functional dyspepsia but endoscopic or radiographic/ultrasound studies are usually necessary to ensure the appropriate diagnosis. Less common organic causes of dyspepsia not to be overlooked include drugs, pancreatitis, malabsorption syndromes, metabolic disorders, ischemic heart disease, and collagen vascular disorders.
器质性和功能性。总体而言，大多数消化不良患者没有潜在的可识别疾病过程。器质性病因在年轻患者中的诊断率较低，相反，严重的器质性病变在老年消化不良患者中很常见。消化不良最常见的器质性病因是消化性溃疡病、胃食管反流、胆道疾病和胃癌。症状和体征可能有助于将这些器质性病因与功能性消化不良区分开来，但通常需要进行内镜检查或影像学/超声检查以确保做出恰当诊断。不可忽视的较不常见的消化不良器质性病因包括药物、胰腺炎、吸收不良综合征、代谢紊乱、缺血性心脏病和胶原血管疾病。
