Dispepsia, SKDI 4A

Summary

The video discusses dyspepsia, a condition marked by symptoms such as fullness after meals, early satiety, and epigastric pain. It explains the difference between functional and organic dyspepsia and highlights diagnostic approaches, including physical exams, endoscopy, and imaging. The video also outlines treatment options based on symptom predominance, using proton pump inhibitors or prokinetics for symptom relief. Emphasis is placed on managing lifestyle factors like diet modification and considering alarm symptoms for further investigation. The video provides a thorough approach to diagnosis and management, focusing on practical steps for healthcare providers.

Takeaways

• 😀 Dispepsia is a condition characterized by symptoms like feeling full after eating, early satiety, epigastric pain, and burning sensations in the epigastrium.
• 😀 Dispepsia is classified into organic (caused by underlying conditions) and functional (without an identifiable underlying disease) forms.
• 😀 To differentiate between organic and functional dyspepsia, medical tests like Urea Breath Test, endoscopy, and ultrasound are conducted.
• 😀 Functional dyspepsia is divided into two subtypes: Post-Prandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS).
• 😀 PDS is linked to delayed gastric emptying, causing feelings of fullness and early satiety after meals.
• 😀 EPS is caused by excessive secretion of gastric acid (HCL), leading to epigastric pain and burning sensations, unrelated to food intake.
• 😀 Symptoms like progressive dysphagia, unexplained weight loss, or a family history of cancer require immediate referral for further investigation.
• 😀 The diagnostic process for functional dyspepsia involves physical exams, medical history, and ruling out organic causes before proceeding with treatments.
• 😀 In managing functional dyspepsia, dietary modifications (e.g., avoiding acidic, spicy, and fatty foods) are recommended, along with smaller, more frequent meals.
• 😀 Treatment for functional dyspepsia varies based on symptoms: PDS may be treated with prokinetic agents, while EPS may require proton pump inhibitors and cytoprotective agents.
• 😀 If symptoms persist despite initial treatment, further measures such as antidepressants or anxiety-relieving drugs may be considered for managing stress-related dyspepsia.

Q & A

What is dyspepsia, and how is it categorized?

Dyspepsia is a condition characterized by a group of symptoms including a feeling of fullness after eating, early satiety, epigastric pain, and burning sensations in the upper abdomen. It is categorized into two types: organic dyspepsia, which is caused by an underlying disease, and functional dyspepsia, which occurs without an identifiable cause.

What are the common symptoms of dyspepsia?

Common symptoms of dyspepsia include a feeling of fullness after meals, early satiety, epigastric pain, and a burning sensation in the upper abdomen (epigastrium).

What is the difference between organic and functional dyspepsia?

Organic dyspepsia is caused by underlying diseases such as infection, gastritis, or cancer, while functional dyspepsia occurs without an identifiable disease. Functional dyspepsia can be further categorized into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).

How is organic dyspepsia diagnosed?

Organic dyspepsia is diagnosed through tests such as urea breath tests to check for Helicobacter pylori infection, endoscopy to detect conditions like cancer or erosive gastritis, and ultrasound (USG) to examine the upper gastrointestinal tract.

What are the two types of functional dyspepsia, and how are they different?

The two types of functional dyspepsia are postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). PDS is characterized by a feeling of fullness and early satiety after eating, often due to delayed gastric emptying. EPS is characterized by epigastric pain and burning, caused by excessive gastric acid secretion.

What are alarm symptoms, and why are they important in dyspepsia diagnosis?

Alarm symptoms include factors such as age over 50, a history of gastrointestinal bleeding, progressive dysphagia (difficulty swallowing), a family history of cancer, and unexplained weight loss. These symptoms are important because they may indicate the presence of a more serious underlying condition, and such patients should be referred for further diagnostic testing like endoscopy.

What is the first step in diagnosing functional dyspepsia?

The first step in diagnosing functional dyspepsia is conducting a thorough physical examination, taking a detailed patient history (anamnesis), and ruling out possible organic causes, such as medication use or gastric irritants like herbal medicine that may cause gastropathy.

How is functional dyspepsia treated?

The treatment for functional dyspepsia starts with dietary modifications, such as avoiding foods that irritate the stomach (acidic, spicy, or fatty foods) and eating smaller, more frequent meals. If symptoms persist, treatments such as proton pump inhibitors (PPIs) or prokinetics (like domperidone) are used depending on the predominant symptoms.

What are proton pump inhibitors (PPIs), and when are they used in dyspepsia treatment?

Proton pump inhibitors (PPIs), such as omeprazole and lansoprazole, are medications used to reduce gastric acid secretion. They are typically used for treating epigastric pain syndrome (EPS), where excessive acid secretion is a key issue.

When should patients with dyspepsia be referred for endoscopy?

Patients with dyspepsia should be referred for endoscopy if alarm symptoms are present, such as advanced age, history of gastrointestinal bleeding, or progressive swallowing difficulties. If no alarm symptoms are found but the condition persists or worsens despite treatment, endoscopy may also be considered to rule out organic causes.