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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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Gastritis III: Clinical Manifestations and Management01:23

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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies01:28

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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
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Peptic Ulcer Disease IV: Management01:26

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Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
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Peptic Ulcer Disease I: Introduction01:30

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Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
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Evidence-based clinical practice guidelines for functional dyspepsia 2021.

Hiroto Miwa1,2, Akihito Nagahara3, Akihiro Asakawa3

  • 1Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Functional Dyspepsia", The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan. miwahgi@hyo-med.ac.jp.

Journal of Gastroenterology
|January 21, 2022
PubMed
Summary
This summary is machine-generated.

Revised guidelines for functional dyspepsia (FD) now recommend endoscopy only when organic disease is suspected. Treatment options have been updated, with new first-line and second-line drug regimens for managing this common gastrointestinal disorder.

Keywords:
AlgorithmAntianxiety drugAntidepressantChronic gastritisDyspepsiaGuidelineH. pylori eradication treatmentH. pylori-associated dyspepsiaJapanese traditional medicineProkineticsProton pump inhibitor

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Area of Science:

  • Gastroenterology
  • Clinical Practice Guidelines

Background:

  • Functional dyspepsia (FD) is a prevalent condition significantly impacting patient quality of life.
  • FD gained national insurance recognition in Japan in 2013, but its recognition is still evolving.
  • The Japanese Society of Gastroenterology (JSGE) has revised its first version of FD guidelines.

Purpose of the Study:

  • To update the clinical practice guidelines for functional dyspepsia (FD) based on the latest evidence.
  • To refine diagnostic approaches and treatment strategies for FD patients.

Main Methods:

  • Guidelines were developed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.
  • Clinical questions were categorized into background questions (BQs), future research questions (FRQs), and treatment-associated clinical questions.

Main Results:

  • Endoscopy is now recommended only when organic disease is suspected, a shift from previous universal requirements for FD diagnosis.
  • Updated first-line treatments include gastric acid-secretion inhibitors, acetylcholinesterase (AChE) inhibitors (acotiamide), and rikkunshito.
  • Second-line treatments encompass anxiolytics/antidepressants, alternative prokinetics, and other Japanese herbal medicines for refractory FD.

Conclusions:

  • The revised guidelines introduce a more targeted approach to FD diagnosis, reducing unnecessary endoscopic procedures.
  • Treatment algorithms for FD have been updated to reflect current evidence, offering a broader range of therapeutic options.
  • These revisions aim to improve the management of functional dyspepsia and address refractory cases more effectively.