Dispepsi

Dispepsi, or dyspepsia, is a term used for uncomfortable symptoms in the upper abdomen. Common features include postprandial fullness, early satiety, epigastric burning or pain, bloating, belching, and sometimes nausea. The condition is typically classified as organic or functional. Organic dyspepsia is caused by identifiable diseases such as peptic ulcer disease, gastritis, gastroesophageal reflux disease, pancreatic or biliary disorders, or, in older individuals, gastric cancer. Functional dyspepsia refers to symptoms without an identifiable structural or biochemical abnormality after standard evaluation.

Evaluation usually begins with a medical history and physical examination. Alarm features such as unintended weight loss, persistent vomiting, signs of anemia, gastrointestinal bleeding, dysphagia, or a new onset of symptoms in older adults warrant urgent investigation, including endoscopy. Testing for Helicobacter pylori infection is common, using noninvasive stool antigen or urea breath tests, with eradication therapy if positive. Endoscopy is recommended for patients with persistent symptoms despite treatment, those with red-flag features, or older patients at the time of presentation.

Management focuses on symptom relief and addressing underlying causes. Lifestyle modifications, such as eating smaller meals, avoiding fatty or spicy foods, caffeine, and NSAIDs, are advised. Pharmacologic therapy includes proton pump inhibitors as first-line therapy for acid suppression, and H2 receptor antagonists or prokinetic agents as alternatives. If H. pylori is present, a defined eradication regimen is used. In functional dyspepsia, psychosocial factors may be relevant and, in some cases, low-dose antidepressants can be considered. Most cases are managed effectively in primary care, with many patients improving over time.