[APPROACH TO A PATIENT WITH DYSPEPSIA IN FAMILY MEDICINE PRACTICE].

Area of Science:

• Family Medicine
• Gastroenterology
• Internal Medicine

Background:

• Dyspepsia is a prevalent symptom in primary care, affecting approximately 40% of the adult population.
• Functional dyspepsia accounts for two-thirds of dyspepsia cases.
• Management strategies are individualized based on patient age, symptom profile, and Helicobacter pylori status.

Purpose of the Study:

• To outline clinical assessment, diagnostic procedures, and treatment strategies for dyspepsia in a family medicine setting.
• To emphasize the importance of considering concurrent diseases and medications in dyspepsia management.
• To highlight the role of diagnostic tools like endoscopy and ultrasound in primary care for dyspepsia.

Main Methods:

• Clinical assessment guided by patient age, symptoms, and Helicobacter pylori infection status.
• Stratified diagnostic approaches: early endoscopy for patients over 50 with alarming symptoms, 'test and treat' for those under 50.
• Integration of ultrasound diagnostics for hepatobiliary and pancreatic conditions presenting with dyspeptic symptoms.
• Consideration of concurrent mental health disorders and their impact on dyspepsia management.

Main Results:

• Prompt endoscopy is recommended for older patients (over 50) with new-onset dyspepsia and alarming symptoms.
• The 'test and treat' approach is suggested for younger patients (<50).
• Acid suppression is a common treatment; further endoscopic evaluation is indicated for treatment failures.
• Ultrasound can aid early diagnosis of hepatobiliary and pancreatic diseases.
• Addressing mental health comorbidities can improve dyspepsia symptoms.

Conclusions:

• Dyspepsia management requires a tailored approach considering patient demographics, clinical presentation, and potential underlying conditions.
• Primary care physicians play a crucial role in diagnosing and managing dyspepsia, utilizing tools like endoscopy and ultrasound.
• For refractory cases, ongoing support, psychotherapeutic interventions, and addressing psychological comorbidities are vital for improving patient outcomes and encouraging healthy behaviors.