PRISTUP BOLESNIKU S DISPEPSIJOM U OBITELJSKOJ MEDICINI

Autor: INES DIMINIĆ-LISICA, BISERKA BERGMAN MARKOVIĆ, LEONARDO BUKMIR, NINA BAŠIĆ MARKOVIĆ, NIVES RADOŠEVIĆ QUADRANTI, IVA LISICA
Jazyk: chorvatština
Rok vydání: 2015
Předmět:
Zdroj: Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske
Volume 69
Issue 4
ISSN: 1848-8897
1330-0164
Popis: Dispepsija je čest simptom u bolesnika koji posjećuju ordinaciju obiteljske medicine. Prevalencija u odrasloj populaciji iznosi oko 40 %. Dvije trećine bolesnika ima funkcionalnu dispepsiju. Klinička procjena, dijagnostički postupak i liječenje bolesnika ovisi o dobi, simptomima i infekciji bakterijom Helicobacter pylori. U bolesnika s dispepsijom neophodno je procijeniti mogući učinak drugih istodobnih bolesti i lijekova koje bolesnik redovito koristi. Promptna ili rana endoskopija preporučuje se bolesnicima sa simptomima alarma i starijima od 50 godina s novonastalom dispepsijom. U mlađih od 50 godina preporučena strategija je „testiraj i tretiraj“. U dijelu bolesnika liječenje se provodi supresijom kiseline. U bolesnika u kojih se ne postiže uspjeh, provodi se daljnja endoskopska dijagnostika. Ultrazvučna dijagnostika na razini primarne zdravstvene zaštite može značajno doprinijeti u dijagnostičkoj procjeni i ranom liječenju bolesnika s bolestima hepatobilijarnog trakta i pankreasa, a koji se prezentiraju simptomima dispepsije. Liječenje istodobnog psihičkog poremećaja može unaprijediti simptome dispepsije. Liječenje bolesnika koji ne odgovaraju na preporučene strategije liječenja izazov je za obiteljskog liječnika. Redoviti posjeti i psihoterapijska potpora u ovih bolesnika mogu reducirati razinu anksioznosti te ohrabriti bolesnika u liječenju prikrivenog psihološkog morbiditeta kao i u njegovim nastojanjima zdravog ponašanja.
Dyspepsia is a common symptom among patients in family medicine practice. The prevalence in adult population is about 40%. Two-thirds of patients have functional dyspepsia. Clinical assessment, diagnostic procedures and treatment of patients depend on the age, symptoms and Helicobacter pylori infection. In patients with dyspepsia, it is necessary to assess the potential impact of other concurrent diseases and medications that the patient regularly uses. Prompt or early endoscopy is recommended in patients with newly detected dyspepsia older than 50 and presenting with alarming symptoms. In persons younger than 50, the recommended strategy is ‘test and treat’. In some patients, treatment is carried out by acid suppression. In patients failing to achieve success in treatment, further endoscopic diagnosis is indicated. Ultrasound diagnostics in primary care can significantly contribute to diagnostic evaluation and early treatment in patients with hepatobiliary and pancreas diseases presenting with symptoms of dyspepsia. Treatment of concurrent mental disorders can improve the symptoms of dyspepsia. Treatment of patients who do not respond to the recommended treatment strategies is a challenge for family physicians. Regular visits and psychotherapeutic support in these patients can reduce the level of anxiety and encourage the patient for treatment of psychological morbidity, as well as his efforts in healthy behavior.
Databáze: OpenAIRE
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