Agustos 2008
Fonksiyonel dispepsinin degerlendirilmesinde klinik yaklasim
Clinical approach in evaluation of functional dyspepsia
- Ana Sayfa
- Sayılar
- Agustos 2008
- Fonksiyonel dispepsinin degerlendirilmesinde klinik yaklasim...
Özet
Giris ve Amaç: Midede mukozal degisiklik saptanmayan hastalarda; dispepsinin yapisal bir bozukluktan çok fonksiyonel bir bozukluga sekonder oldugu düsünülür, bu tabloya ‘fonksiyonel dispepsi’ adi verilir. Çalismamizda gastroenteroloji poliklinigine basvuran hastalarin endoskopik bulgulari ve islem sirasinda alinan biyopsilerde aranan Helikobakter pilori pozitifligi ve histopatolojik bulgular arasindaki iliskiyi degerlendirimeyi, bulgularini kontrol vakalari ile karsilastirmayi ve endoskopinin fonksiyonel dispepsi tani ve tedavisindeki yeri ve etkinligini gözden geçirmeyi amaçladik. Gereç ve Yöntem: Çalismaya toplam 45 olgu alindi, 22’si fonksiyonel dispeptik sikayetleri olan hasta grubunu, asemptomatik 23 olgu ise kontrol grubunu olusturdu. Vakalarin tamamina tek bir klinisyen tarafindan özofago-gastroduodenoskopi yapildi ve antrumdan biyopsiler alindi. Bulgular: Hasta ve kontrol gruplarindaki olgularin cins ve yas dagilimlari benzerdi. En sik görülen semptom epigastrik yanmaagri ydi. Hasta ve kontrol grubu endoskopik bulgular/Helikobakter pilori varligi / histopatolojik bulgular açisindan karsilastirildiginda gruplar arasinda anlamli fark saptanmadi (p>0.05). Sonuç: Dispeptik sikayetler ile klinige basvuran hastalarda alarm semptomlari yoksa, ön planda fonksiyonel dispepsi düsünülüyorsa endoskopik girisim ve biyopsi alinmasina gerek kalmadan non-invaziv testler ile Helikobakter pilori varligi arastirilmasi ve buna göre eradikasyon tedavisinin yapilmasi ya da amprik olarak diger ajanlar ile tedaviye baslanmasi uygun olacaktir.
Abstract
Background and Aims: In patients without mucosal changes, dyspepsia is thought to be secondary to a disorder of function, rather than structure; hence, the name "functional dyspepsia". We aimed in this study to investigate the relation between endoscopic findings and Helicobacter pylori / histopathologic findings in biopsies taken during endoscopic examination, comparing these findings with control cases, and to review the effectiveness and importance of endoscopic examination in diagnosis and therapy of functional dyspepsia. Materials and Methods: Forty-five patients were included in the study. Twenty-two were classified as the patient group with functional dyspepsia, and 23 asymptomatic cases were classified as the control group. All cases included this study underwent upper gastrointestinal endoscopy by the same physician and antral biopsies were taken during endoscopic examination. Results: Patient and control groups were similar with respect to gender and age. The most common symptom was epigastric pain. Patient and control groups were compared in terms of endoscopic findings, Helicobacter pylori and histopathological changes, and no significant difference was found between the two groups (p>0.05). Conclusions: The "test and treat" strategy is recommended for dyspeptic patients with primarily functional dyspepsia in the absence of alarm symptoms, without necessity of endoscopic examination and biopsies. Patients should be tested for Helicobacter pylori and treated if positive. If Helicobacter pylori is negative, other treatment options should be started empirically.
