PMID- 19153486
OWN - NLM
STAT- MEDLINE
DCOM- 20090406
LR  - 20090120
IS  - 1421-9867 (Electronic)
IS  - 0012-2823 (Linking)
VI  - 79 Suppl 1
DP  - 2009
TI  - Stepwise diagnosis and treatment from uninvestigated dyspepsia to functional 
      dyspepsia in clinical practice in Japan: proposal of a 4-step algorithm.
PG  - 19-25
LID - 10.1159/000167862 [doi]
AB  - BACKGROUND/AIM: Management of dyspepsia may differ between countries. In Japan, 
      Helicobacter pylori infection should be considered because of the high prevalence 
      of the infection and the related diseases. I tried to propose an algorithm for 
      stepwise diagnosis and treatment from uninvestigated dyspepsia to functional 
      dyspepsia in clinical practice in Japan. METHODS: A proposal was made from my 
      personal review of published studies. RESULTS: A 4-step algorithm was proposed. 
      In the first step, organic, systemic or metabolic diseases are excluded and 
      nonulcer dyspepsia (NUD) is diagnosed. The second step is to test and treat H. 
      pylori infection for NUD patients. In the third step, proton pump inhibitor 
      (PPI)-responsive NUD is discriminated by PPI. Nonresponsive patients in the third 
      step are diagnosed as having PPI-resistant NUD. In the fourth step, functional 
      dyspepsia is diagnosed with the Rome III questionnaire. In this algorithm, it is 
      not necessary to do special function tests for functional gastrointestinal 
      disorders. Treatment options are automatically restricted in each step. 
      CONCLUSIONS: The proposed 4-step algorithm may be useful in clinical practice for 
      the diagnosis from uninvestigated dyspepsia to functional dyspepsia in Japan. 
      With this stepwise algorithm, treatment options are restricted in each step and 
      the management of dyspepsia may be easier.
CI  - Copyright 2009 S. Karger AG, Basel.
FAU - Nakajima, Shigemi
AU  - Nakajima S
AD  - Departments of Medicine, Gastroenterology and Healthcare, Social Insurance Shiga 
      Hospital, Shiga, Japan. shigemin@rainbow.plala.or.jp
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090120
PL  - Switzerland
TA  - Digestion
JT  - Digestion
JID - 0150472
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - *Algorithms
MH  - Dyspepsia/classification/*diagnosis/therapy
MH  - Helicobacter Infections/diagnosis/drug therapy
MH  - Humans
MH  - Japan
MH  - Proton Pump Inhibitors/therapeutic use
RF  - 23
EDAT- 2009/01/30 09:00
MHDA- 2009/04/07 09:00
CRDT- 2009/01/21 09:00
PHST- 2009/01/21 09:00 [entrez]
PHST- 2009/01/30 09:00 [pubmed]
PHST- 2009/04/07 09:00 [medline]
AID - 000167862 [pii]
AID - 10.1159/000167862 [doi]
PST - ppublish
SO  - Digestion. 2009;79 Suppl 1:19-25. doi: 10.1159/000167862. Epub 2009 Jan 20.