Dyspepsia has plagued humankind for centuries (1). Symptoms from the upper and lower gastrointestinal tract, such as abdominal pain and discomfort, heartburn or bowel habit disturbances, are common; up to one in three report such complaints, in population-based studies in the Western world. I have therefore performed a series of studies to shed light on these issues: The first study (Paper I) was performed in a randomly selected adult population (n=1,001) assessing upper and lower gastrointestinal symptoms at two occasions with 1 to 6 month intervals. The results show that gastrointestinal symptoms are common (57%) and fluctuate to some extent in the shorter term. Troublesome dyspeptic symptoms remain in two out of three individuals. This proportion was similar whether or not organic findings were present. In the second study (Paper II) 799 patients with dyspeptic symptoms…
Contents
Introduction
Background
Historical perspective
Definition and clinical presentation of patients with dyspepsia
The terminology: dyspepsia and functional dyspepsia
Symptoms in functional dyspepsia
Subclassification of patients with functional dyspepsia
Epidemiology
Pathophysiology
Mucosal inflammation and Helicobacter pylori infection
Visceral hypersensitivity
Gastric acid and undiagnosed gastroesophageal reflux disease
Duodenogastric reflux
Gastrointestinal dysmotility
Psychological factors
Other factors
Health-related quality of life
Clinical management
Consultation in clinical practice
Current treatment modalities
Aims of the studies
Materials and methods
Gastrointestinal symptoms assessments
Definition of endoscopic findings
24-hour pH monitoring of esophageal acid exposure
Health-related quality of life assessments
Statistics
Ethics
Summary of papers
Paper I
Conclusion
Paper II
Conclusion
Paper III
Conclusion
Paper IV
Conclusion
Paper V
Conclusion
General discussion
Summary and overall conclusion
Acknowledgements
References
Author: Bolling-Sternevald, Elisabeth
Source: Linköping University
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