Dyspepsi och reflux. Systematisk litteraturöversikt från SBU

Staël von Holstein, Christer; Norlund, Anders

Dyspepsi och reflux. Systematisk litteraturöversikt från SBU

Mark

Staël von Holstein, Christer ^LU and Norlund, Anders (2007) In Läkartidningen 104(18). p.7-1414

Abstract: SBU performed a systematic review concerning dyspepsia and gastroesophageal reflux disease (GERD). The review included the perspective of managing patients in primary care. Dyspepsia is a common condition but varies from one geographic area to another. Despite presenting symptoms of dyspepsia, a majority of patients may not have an ulcer diagnosis (non-ulcer dyspepsia [NUD]). For undiagnosed GERD and diagnosed erosive GERD, proton pump inhibitors (PPIs) provide better relief of symptoms than histamine-H2 antagonists. When it comes to long-term treatment of erosive GERD, continued use of PPIs leads to better patient outcomes than PPIs on demand. PPIs are safe for long-term treatment and indicated even for young patients. Adverse effects are... (More); SBU performed a systematic review concerning dyspepsia and gastroesophageal reflux disease (GERD). The review included the perspective of managing patients in primary care. Dyspepsia is a common condition but varies from one geographic area to another. Despite presenting symptoms of dyspepsia, a majority of patients may not have an ulcer diagnosis (non-ulcer dyspepsia [NUD]). For undiagnosed GERD and diagnosed erosive GERD, proton pump inhibitors (PPIs) provide better relief of symptoms than histamine-H2 antagonists. When it comes to long-term treatment of erosive GERD, continued use of PPIs leads to better patient outcomes than PPIs on demand. PPIs are safe for long-term treatment and indicated even for young patients. Adverse effects are rare. Eradication of H. pylori reduces the risk of duodenal ulcer and ventricular ulcer. Eradication of H. pylori is more effective than acid suppression alone for preventing a new episode of bleeding. Eradication of H. pylori for patients with NUD may provide minor relief of symptoms. But because the majority of patients with NUD are not infected with H. pylori, the treatment will have no effect on them. PPIs may provide some relief of NUD symptoms, but studies that analyzed the effectiveness of PPIs for NUD symptoms also included patients with GERD. As a result, it is difficult to draw any conclusions in that regard. Patients with Barrett's esophagus are at increased risk of developing adenocarcinoma of the esophagus. However, published studies offer no evidence that screening or surveillance will detect cancer at an early stage. There is a need for independent dyspepsia research, including health economic studies. (Less)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/539996

author

Staël von Holstein, Christer ^LU and Norlund, Anders

organization

Surgery (Lund)

alternative title

Dyspepsia and reflux. Systematic literature review from SBU

publishing date

2007

type

Contribution to journal

publication status

published

subject

Surgery

keywords

Adenocarcinoma: etiology, Adult, Antacids: therapeutic use, Barrett Esophagus: complications, Barrett Esophagus: diagnosis, Barrett Esophagus: drug therapy, Dyspepsia: diagnosis, Dyspepsia: drug therapy, Esophageal Neoplasms: etiology, Esophagitis: complications, Esophagitis: drug therapy, Female, Gastroesophageal Reflux: complications, Gastroesophageal Reflux: diagnosis, Gastroesophageal Reflux: drug therapy, Helicobacter Infections: complications, Proton Pumps: antagonists & inhibitors, Peptic Ulcer: microbiology, Peptic Ulcer: drug therapy, Male, Humans, Helicobacter Infections: drug therapy, Helicobacter pylori, Risk Factors

in

Läkartidningen

volume

104

issue

18

pages

7 - 1414

publisher

Swedish Medical Association

external identifiers

scopus:34248390202

ISSN

0023-7205

language

Swedish

LU publication?

yes

id

bb6d99cb-58bf-4c26-a5d7-54cf3bb5c321 (old id 539996)

alternative location

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17550016&dopt=Abstract

http://ltarkiv.lakartidningen.se/artNo33377

date added to LUP

2016-04-01 16:54:52

date last changed

2022-01-28 23:01:14

@article{bb6d99cb-58bf-4c26-a5d7-54cf3bb5c321,
  abstract     = {{SBU performed a systematic review concerning dyspepsia and gastroesophageal reflux disease (GERD). The review included the perspective of managing patients in primary care. Dyspepsia is a common condition but varies from one geographic area to another. Despite presenting symptoms of dyspepsia, a majority of patients may not have an ulcer diagnosis (non-ulcer dyspepsia [NUD]). For undiagnosed GERD and diagnosed erosive GERD, proton pump inhibitors (PPIs) provide better relief of symptoms than histamine-H2 antagonists. When it comes to long-term treatment of erosive GERD, continued use of PPIs leads to better patient outcomes than PPIs on demand. PPIs are safe for long-term treatment and indicated even for young patients. Adverse effects are rare. Eradication of H. pylori reduces the risk of duodenal ulcer and ventricular ulcer. Eradication of H. pylori is more effective than acid suppression alone for preventing a new episode of bleeding. Eradication of H. pylori for patients with NUD may provide minor relief of symptoms. But because the majority of patients with NUD are not infected with H. pylori, the treatment will have no effect on them. PPIs may provide some relief of NUD symptoms, but studies that analyzed the effectiveness of PPIs for NUD symptoms also included patients with GERD. As a result, it is difficult to draw any conclusions in that regard. Patients with Barrett's esophagus are at increased risk of developing adenocarcinoma of the esophagus. However, published studies offer no evidence that screening or surveillance will detect cancer at an early stage. There is a need for independent dyspepsia research, including health economic studies.}},
  author       = {{Staël von Holstein, Christer and Norlund, Anders}},
  issn         = {{0023-7205}},
  keywords     = {{Adenocarcinoma: etiology; Adult; Antacids: therapeutic use; Barrett Esophagus: complications; Barrett Esophagus: diagnosis; Barrett Esophagus: drug therapy; Dyspepsia: diagnosis; Dyspepsia: drug therapy; Esophageal Neoplasms: etiology; Esophagitis: complications; Esophagitis: drug therapy; Female; Gastroesophageal Reflux: complications; Gastroesophageal Reflux: diagnosis; Gastroesophageal Reflux: drug therapy; Helicobacter Infections: complications; Proton Pumps: antagonists & inhibitors; Peptic Ulcer: microbiology; Peptic Ulcer: drug therapy; Male; Humans; Helicobacter Infections: drug therapy; Helicobacter pylori; Risk Factors}},
  language     = {{swe}},
  number       = {{18}},
  pages        = {{7--1414}},
  publisher    = {{Swedish Medical Association}},
  series       = {{Läkartidningen}},
  title        = {{Dyspepsi och reflux. Systematisk litteraturöversikt från SBU}},
  url          = {{http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17550016&dopt=Abstract}},
  volume       = {{104}},
  year         = {{2007}},
}

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Dyspepsi och reflux. Systematisk litteraturöversikt från SBU