Department of Medicine, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
J Neurogastroenterol Motil. 2013 Jul;19(3):295-300. doi: 10.5056/jnm.2013.19.3.295. Epub 2013 Jul 8.
Despite being a large ethnic group within the South-East Asia, there is a paucity of reported literatures on dyspepsia in the Malay population. Recent population-based studies indicate that uninvestigated dyspepsia, based on the Rome II criteria, is reported in 12.8% and 11.6% of Malays in the urban and rural communities respectively. Organic causes of dyspepsia including upper gastrointestinal tract cancers, its precancerous lesions, and erosive diseases are uncommon which is largely due to an exceptionally low prevalence of Helicobacter pylori infection in this population. On the other hand, functional dyspepsia and irritable bowel syndrome are relatively common in the Malays than expected. Within a primary care setting, functional dyspepsia, based on the Rome III criteria, is reported in 11.9% of Malays, of which epigastric pain syndrome is found to be more common. Married Malay females are more likely to have functional dyspepsia and psychosocial alarm symptoms. Also based on the Rome III criteria, irritable bowel syndrome, commonly overlapped with functional dyspepsia, is reported in 10.9% of Malays within a community-based setting. Rather than psychosocial symptoms, red flags are most likely to be reported among the Malays with irritable bowel syndrome despite having a low yield for organic diseases. Based upon the above observations, "proton pump inhibitor test" is probably preferable than the "test and treat H. pylori" strategy in the initial management of dyspepsia among the Malays.
尽管马来人是东南亚的一个大族群,但有关马来人消化不良的文献却很少。最近的基于人群的研究表明,根据罗马 II 标准,城市和农村社区分别有 12.8%和 11.6%的马来人患有未经调查的消化不良。消化不良的器质性原因,包括上消化道癌症、其癌前病变和侵蚀性疾病并不常见,这主要是由于该人群中幽门螺杆菌感染的患病率极低。另一方面,功能性消化不良和肠易激综合征在马来人中比预期的更为常见。在初级保健环境中,根据罗马 III 标准,马来人中有 11.9%患有功能性消化不良,其中上腹痛综合征更为常见。已婚的马来女性更有可能患有功能性消化不良和心理社会报警症状。同样根据罗马 III 标准,在社区环境中,10.9%的马来人患有肠易激综合征,该病常与功能性消化不良重叠。尽管器质性疾病的检出率较低,但与肠易激综合征相关的马来人更可能报告的是危险信号,而不是心理社会症状。基于上述观察结果,在马来人消化不良的初始管理中,“质子泵抑制剂试验”可能优于“检测和治疗幽门螺杆菌”策略。