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Epidemiology, approach and management of functional dyspepsia in Thailand
Author(s) -
Kachintorn Udom
Publication year - 2011
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2011.06647.x
Subject(s) - medicine , intensive care medicine , drug , epidemiology , pharmacotherapy , placebo , clinical trial , alternative medicine , psychiatry , pathology
Background and aim: Functional dyspepsia (FD) represents one of the important GI disorders confronting clinicians worldwide including Thailand. FD is a clinical syndrome with various underlying pathophysiologies, and their treatment remains a major challenge. This article aims at the approach of FD and its management. Method: For current situation, optimal therapy includes non‐drug therapy namely reassurance by ruling out relevant differential diagnoses, general advice with regard to the underlying causes, dietary measures, lifestyle modification, and good doctor‐patient relationship. Removing precipitating causes, such as medications, food or psychological factors/stress contributing to symptoms, is mandatory. A wide variety of drug treatments have been used to manage FD including antisecretory agents, prokinetics and H.pylori eradication. Results: It is understandable that there is no ideal drug available. The overall gain over placebo ranges from less than 5% for H.pylori eradication to 15%‐20% for antisecretory agents and prokinetics. Conclusion: Drug therapy includes acid inhibitory agents, prokinetics and H.pylori eradication are still the mainstay and should be adjusted accordingly on a case‐by‐case basis. In the future, it would be logical to develop multi‐target therapies that simultaneously address various underlying mechanisms.