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关于功能性消化不良患者管理的比利时共识
S Kindt1,2, J Arts3, P Caenepeel4
1Vrije Universiteit Brussel (VUB), Brussels Health Campus/Faculty of Medicine and Pharmacy, Vitality Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium.
Acta gastro-enterologica Belgica
|June 12, 2025
概括
功能性消化不良 (FD) 是一种常见的肠脑疾病. 这个比利时的共识强调了它的多因素原因,并建议放心,改变生活方式和PPI作为一线治疗,建议不要限制饮食和侵入性手术.
科学领域:
- 胃肠病学 胃肠病学
- 肠-大脑相互作用障碍 肠-大脑相互作用障碍
- 功能性消化不良的研究研究.
背景情况:
- 功能性消化不良 (FD) 是一种普遍存在的肠-大脑相互作用障碍,其特征是腹上疼痛,灼热,早期和食后腹.
- 尽管患病率很高,但对临床医生来说,FD的诊断和管理仍然具有挑战性.
- FD与其他肠-大脑相互作用障碍 (DGBIs) 共享症状,并且可以与诸如刺激性肠综合征 (IBS) 等疾病共存.
研究的目的:
- 建立比利时专家在功能性消化不良的病因,表现,诊断和治疗方面达成共识.
- 提供针对比利时医疗保健系统量身定制的基于证据的建议.
- 确定FD管理领域未来研究的领域.
主要方法:
- 一个德尔菲的共识过程,涉及20名专家.
- 综合文献综述,总结现有证据.
- 投票对119个声明进行了表决,共识定义为>80%的同意.
- 推,评估,发展和评价 (GRADE) 标准的分级的应用.
主要成果:
- FD具有多因素的病因,也观察到胀气和体重减轻.
- 建议根据症状表现 (例如,食后) 划分FD亚型.
- 鼓励积极诊断;除非存在警报特征或耐火症状,否则不需要进行例行额外测试.
- 建议使用质子抑制剂 (PPI) 作为一线药理治疗.
- 协商一致建议不要进行碳水化合物吸收不良测试,pyloric阻抗平面测量,pH/阻抗监测,食物过敏测试,透性测试,限制性饮食,侵入性手术,腹腔营养,抗生素,抗药和阿片类药物.
结论:
- 比利时专家建议对FD进行正确诊断,强调解释,放心和改变生活方式.
- 质子抑制剂是首选的第一线药理疗法.
- 共识强烈建议不要进行限制性饮食和侵入性干预,用于FD管理.
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