Functional dyspepsia: treatment
Last reviewed: 23.04.2024
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Objectives of treatment of functional dyspepsia
Reduction of clinical symptoms. Prevention of the epidemics.
Indications for hospitalization
Hospitalization is indicated when it is necessary to conduct a complex examination and difficulties in the differential diagnosis.
Treatment of patients with functional dyspepsia syndrome should be comprehensive and include measures to normalize the lifestyle, the regime and the nature of nutrition, medical therapy, if necessary, psychotherapeutic methods.
Non-pharmacological treatment of functional dyspepsia
Mode
Changing the way of life involves the elimination of physical and emotional overloads, which can adversely affect the motility of the gastrointestinal tract, the exclusion of smoking and alcohol.
Diet
Avoid prolonged breaks in food intake, consumption of fatty and spicy food, preservatives, marinades, smoked products, coffee, carbonated drinks.
Food should be taken in small portions, thoroughly chewed and evenly swallowed.
Drug therapy of functional dyspepsia
Assign depending on the variant of the disease. With an ulcerative variant, antacids are prescribed (aluminum hydroxide + magnesium hydroxide 1 dose at 1.5-2 h after meals and at bedtime) and antisecretory drugs (proton pump inhibitors are preferable to histamine H2-receptor blockers) in a usual daily dose.
In the dyskinetic version, prokinetic drugs are prescribed, normalizing the motor function of the stomach: domperidone (10 mg 3-4 times a day for 15-20 minutes before meals). Domperidone does not penetrate the blood-brain barrier, so it has fewer side effects compared to metoclopramide. With a nonspecific variant of functional dyspepsia, prokinetics is administered in combination with antisecretory drugs. Functional dyspepsia associated with H. Pylori is attributed to Maastricht Consensus III (2005) to the group of diseases in which it is advisable to carry out eradication therapy, since in part of the patients (about 25%) it contributes to a long-term improvement in well-being and prevents the development of atrophic gastritis or peptic ulcer disease .
Further management of the patient
With the ineffectiveness of some drugs in patients with functional dyspepsia without "disturbing" signs carried trial treatment with another group (prokinetics antagonists, H 2 receptor antagonists of histamine, proton pump inhibitors).
It should be remembered about the possibility of bleeding, weight loss and dysphagia. If these symptoms occur, the diagnosis of functional dyspepsia is excluded, and the patient is referred for consultation to the gastroenterologist.
In patients who received eradication therapy, a study should be conducted on H. Pylori to confirm the result of eradication therapy.
Patient education
The patient is explained the essence of ongoing diagnostic and therapeutic interventions: dyspepsia at a young age without "disturbing" signs is rarely associated with serious gastrointestinal diseases, such as stomach cancer, complicated peptic ulcer and gastroesophageal reflux disease; dyspepsia can be treated with short-term courses of drugs.
Prognosis of functional dyspepsia
In connection with the lack of an organic cause of functional dyspepsia, the prognosis can be considered favorable, although the disease worsens the quality of life of patients. For functional dyspepsia is characterized by a recurrence of symptoms, so the probability of resumption of the disease after the course of treatment is preserved.
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