title: Diagnosis and treatment of dyspeptic patients in Japan.
abstract: OBJECTIVE
  Although functional gastrointestinal (GI) disorders has been paid more attention recently in Japan, similar to Western countries, the clinical characteristics of dyspeptic patients, current diagnostic approach to dyspeptic patients and current standard treatments for dyspeptic patients are not well known in Japan. This review, in the most part, summarizes two topics about Japanese dyspeptic patients. The first topic is the pros and cons of the diagnosis of Japanese dyspeptic patients using Rome III classification on the basis of our data and the second topic deals with standard treatments for dyspeptic patients-especially by primary care doctors in Japan.
  
  
  METHODS
  We conducted a PubMed search using the following key words alone or in combination: functional dyspepsia (FD), medical treatment, Rome III classification and Japanese.
  
  
  RESULTS
  The Rome III classification for FD does not adequately identify a large proportion of Japanese dyspeptic patients, primarily due to their earlier presentation for medical evaluation. There are many kinds of options for the treatment of FD in Japan: proton-pump inhibitors, histamine H(2) receptor antagonists, mucoprotective agents, Japanese traditional herbal medicines, Helicobacter pylori eradication therapy and prokinetics. Under the current situation, Japanese primary care doctors choose drugs according to each subtype of FD, which means that they prescribe medicine according to the pathogenesis of each patient.
  
  
  CONCLUSIONS
  While the Rome III classification seems logical, some aspects need further evaluation for Japanese dyspeptic patients. Japanese primary care doctors choose drugs appropriately based on the pathogenesis of FD. However, efforts to further elucidate underlying pathophysiologic mechanisms and identify the appropriate patient population using modified Rome classification will be required.
authors: Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan. n_manabe@hkg.odn.ne.jp
authors: Noriaki
authors: N
authors: Manabe
authors: Ken
authors: K
authors: Haruma
mesh_terms: D044466:Asian People; D004415:Dyspepsia / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents