GASTROENTEROLOGY ARTICLE OF THE WEEK
April 6, 2006
Talley NJ, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol 2006;100:2324-2337
1. Which of the following symptoms are not consistent with dyspepsia?
a. Early satiety
b. Severe epigastric sharp pain
c. Heartburn
d. Upper abdominal fullness
e. Diffuse abdominal pain involving the lower quadrants
True or False
2. A 39 y/o Mexican immigrant with typical symptoms of dyspepsia and no alarm symptoms should be tested for H. pylori and if positive, undergo eradication. If H. pylori negative, a trial of a PPI for 4-8 weeks is a reasonable approach
3. Only 15% of patients with functional dyspepsia have delayed gastric emptying
4. Subdividing dyspepsia in groups based on the predominant symptoms does not help guide evaluation or treatment of these patients
5. A 61 y/o man with new onset dyspepsia that is relieved by OTC H2RA can be safely treated with a PPI for 4-8 weeks without further testing
6. The majority of people who test positive for H. pylori and undergo eradication report resolution of their symptoms
7. Empiric prokinetic therapy using cisapride in patients with uninvestigated dyspepsia and no alarm symptoms is of benefit in most
8. For every 15 patients with dyspepsia and H pylori who
undergo H. pylori eradication, 1 will improve