Treatment of functional dyspepsia

被引：13

作者：

Halder S.L.S. ^{[1
]}

Talley N.J. ^{[1
]}

机构：

[1] Mayo Clinic Rochester, Rochester, MN 55905

来源：

Current Treatment Options in Gastroenterology | 2005年 / 8卷 / 4期

关键词：

Irritable Bowel Syndrome; Dyspepsia; Cisapride; Functional Dyspepsia; Irritable Bowel Syndrome Patient;

D O I：

10.1007/s11938-005-0026-8

中图分类号：

学科分类号：

摘要：

Functional dyspepsia (FD) is a common reason a patient presents with upper gastrointestinal symptoms for medical care. Although treatment of FD remains expensive, the agents are rarely used in a systematic manner; the majority of treatments are empirical and the results short lived once therapy is ceased. This is partly due to the lack of consistent pathophysiologic markers in FD, so therapy is symptom driven. This review appraises the best evidence on available interventions. A structured scheme for deciding on appropriate therapies is to consider the possible putative pathophysiologic mechanisms. Eradicating Helicobacter pylori, if present, is a first-line strategy. In patients who have symptoms suggesting excessive gastric acid secretion, particularly epigastric pain, antisecretory agents are recommended. Prokinetics may confer benefits on symptoms suggestive of upper gastrointestinal dysmotility, like fullness or early satiety. However, their use is limited due to availability issues. The expanding field of psychologic therapies provides a promising avenue of treatment. Complementary medicines are now widely use and their benefits have been suggested in recent controlled trials. Emerging treatments include cholecystokinin 1 blockers, opioid receptor agonists, and serotonergic agents, although their application in FD is in the preliminary stages. Copyright © 2005 by Current Science Inc.

引用

页码：325 / 336

页数：11

共 58 条

[31]

Bates S., Sjoden P.O., Nyren O., Behavioral treatment of non-ulcer dyspepsia, Scand. J. Behav. Ther., 17, pp. 155-165, (1988)

[32]

Jackson J.L., O'Malley P.G., Tomkins G., Et al., Treatment of functional gastrointestinal disorders with antidepressant medications: A meta-analysis, Am. J. Med., 108, pp. 65-72, (2000)

[33]

Loldrup D., Langemark M., Hansen H.J., Et al., Clomipramine and mianserin in chronic idiopathic pain syndrome. A placebo controlled study, Psychopharmacology (Berl.), 99, pp. 1-7, (1989)

[34]

Mertz H., Fass R., Kodner A., Et al., Effect of amitriptyline on symptoms, sleep, and visceral perception in patients with functional dyspepsia, Am. J. Gastroenterol., 93, 2, pp. 160-165, (1998)

[35]

Tack J., Broekaert D., Coulie B., Et al., Influence of the selective serotonin re-uptake inhibitor, paroxetine, on gastric sensorimotor function in humans, Aliment. Pharmacol. Ther., 17, pp. 603-608, (2003)

[36]

Tindle H.A., Davis R.B., Phillips R.S., Et al., Trends in use of complementary and alternative medicine by US adults: 1997-2002, Altern. Ther. Health Med., 11, pp. 42-49, (2005)

[37]

Holtmann G., Adam B., Haag S., Et al., Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: A six-week placebo-controlled, double-blind, multicentre trial, Aliment. Pharmacol. Ther., 18, pp. 1099-1105, (2003)

[38]

Thompson Coon J., Ernst E., Herbal medicinal products for non-ulcer dyspepsia, Aliment. Pharmacol. Ther., 16, pp. 1689-1699, (2002)

[39]

Melzer J., Rosch W., Reichling J., Et al., Meta-analysis: Phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast), Aliment. Pharmacol. Ther., 20, pp. 1279-1287, (2004)

[40]

Tack J., Piessevaux H., Coulie B., Et al., Role of impaired gastric accommodation to a meal in functional dyspepsia, Gastroenterology, 115, pp. 1346-1352, (1998)

← 1 2 3 4 5 6 →