PMID- 11068485
OWN - NLM
STAT- MEDLINE
DCOM- 20001201
LR  - 20201208
IS  - 0035-3639 (Print)
IS  - 0035-3639 (Linking)
VI  - 21
IP  - 4
DP  - 2000 Sep
TI  - [Dyspepsia in general medicine: current diagnostic approach].
PG  - A309-13
AB  - Upper GI tract endoscopy remains a key investigation in dyspepsia. Nevertheless, 
      since the development of non-invasive techniques for Helicobacter pylori (Hp) 
      infection detection and the current trend for immediate prescription of anti 
      secretary drugs in "endoscopy negative gastro-oesophageal reflux disease" (NORD), 
      accurate indications for endoscopy must be reconsidered. Careful recording of the 
      medical history of the patient is crucial. Personal antecedents (diseases and 
      drugs), familial history (especially gastric cancer) must be evidenced and three 
      symptomatic groups must be identified: patients with alarm symptom(s), typical 
      ulcer pain and GORD. Beside those three categories, most patients must be 
      classified in "non specific dyspepsia". Immediate endoscopy is highly recommended 
      in all patients with either alarm symptom(s) or typical ulcer pain (except in 
      suspected relapse of a well documented duodenal ulcer disease). Age is a key 
      determinant in GORD: endoscopy is not necessary in patients under 45 years of 
      age. In case of "non specific dyspepsia" in patients under 45 years, a 
      non-invasive test for Hp infection will favour when positive endoscopic 
      investigation ("test and scope" policy). Nevertheless, in all patients above 45 
      years and in all patients with either a personal history of gastric ulcer, or a 
      familial history of gastric cancer (whatever the age), endoscopy with biopsies 
      remains the first recommended investigation.
FAU - Deltenre, M
AU  - Deltenre M
AD  - Service de Gastro-enterologie, C.H.U. Brugmann, U.L.B.
LA  - fre
PT  - Journal Article
PT  - Review
TT  - La dyspepsie en medecine generale: approche diagnostique actualisee.
PL  - Belgium
TA  - Rev Med Brux
JT  - Revue medicale de Bruxelles
JID - 8003474
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Biopsy
MH  - Dyspepsia/classification/*diagnosis/*etiology
MH  - Family Practice/*methods
MH  - Gastroesophageal Reflux/complications
MH  - Gastroscopy
MH  - Helicobacter Infections/complications
MH  - Helicobacter pylori
MH  - Humans
MH  - Medical History Taking
MH  - Middle Aged
MH  - Patient Selection
MH  - Primary Health Care/*methods
RF  - 16
EDAT- 2000/11/09 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/11/09 11:00
PHST- 2000/11/09 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/11/09 11:00 [entrez]
PST - ppublish
SO  - Rev Med Brux. 2000 Sep;21(4):A309-13.