Can the Clinical History Distinguish Between Organic and Functional Dyspepsia?

Martin, Paul; Talley, Nicholas J.; Fennerty, M. Brian; Vakil, Nimish

doi:10.1001/jama.295.13.1566

Cited by 175 publications

(101 citation statements)

References 40 publications

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“…However, a systematic review of seven studies evaluating over 46,000 dyspepsia patients undergoing upper GI endoscopy found that alarm features had limited value ( 32 ). Alarm features also had limited utility in detecting any organic pathology (malignancy, peptic ulcer disease, or esophagitis) ( 33 ). Individual alarm features such as weight loss, anemia, or dysphagia had sensitivities and specifi cities of ~66% with a positive likelihood ratio of 2.74 (95% CI=1.47-5.24) ( 31 ).…”

Section: Conditional Recommendation Moderate Quality Evidencementioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

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520

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Section: Conditional Recommendation Moderate Quality Evidencementioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

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511

520

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“…Patients' history and physical examination are neither sensitive nor specific enough to predict which patients' dyspeptic organic nosology will be detected y endoscopy (144,200) . The low prevalence of cancer in this population and the high rate of irrelevant findings on endoscopy have encouraged the use of empirical treatment (H pylori eradication or a cycle with proton pump inhibitors) before performing an invasive and relatively costly procedure (upper endoscopy with biopsies).…”

Section: Statementmentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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“…13,14 The cost of managing dyspepsia may be reduced if upper GI symptoms could accurately distinguish between organic and functional dyspepsia (FD), but a systematic review has suggested that symptoms perform poorly in this regard. 15 The commonest organic finding at upper GI endoscopy in Western populations with dyspepsia is erosive esophagitis, 16 and over the last 20 years definitions of the condition have been refined substantially, [17][18][19][20] with the main aim of excluding patients with gastro-esophageal reflux disease (GERD), in an attempt to enrich the number of patients with FD.…”

Section: Introductionmentioning

confidence: 99%