[Diagnosis of functional dyspepsia: a systematic review].
This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea.
Jung
Hye-kyung
HK
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Keum
Bo Ra
BR
Jo
Yoon Ju
YJ
Jee
Sam Ryong
SR
Rhee
Poong-Lyul
PL
Kang
Young Woo
YW
D004415:Dyspepsia / Q000175:diagnosis*; D016145:Endoscopy, Digestive System; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans