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Background. Treatment of dyspeptic patients is a diagnostic and therapeutic problem frequently encountered by general and family practitioners, by internists and gastroenterologists. Aims. In our study we attempted to assess the prevalence of dyspeptic symptoms in patients over 60 who are regular users of nonsteroidal antiinflammatory drugs. Patients and methods. This is a prospective cohort study based on on an interview during examination in the OPC, the results obtained by the diagnostic procedures and follow-up. It was carried out between 1999 and 2003 at a family practitioner's and a gastroenterologic OPC. In patients who were regular users of nonsteroidal antiinflammatory drugs, we established the prevalence of dyspeptic symptoms, the most often used drugs and the type of diagnostic procedure applied to define the cause of dyspepsia. The control group was composed of patients over 60 who were also exhibiting dyspeptic symptoms but not using any NSAID. Results. The study comprised 50 patients, 27 women and 23 men, the mean age was 67.3 years, the range 60-80 years. The control group comprised 50 patients, 28 women and 22 men, the mean age was 66.6 years, the range 61-80 years. All patients of the study group had used NSAR or preparations of acetylsalicylic acid during the past 3 months. There were no statistically significant differences between the patients of both groups as regards the number and use of other drugs, p=0.65. The average score of dyspeptic complaints in our study group was 3.02, SD +/- 0.6, and 70 % patients wished to use H2 antagonits or proton pump inhibitors for these complaints. In patients of the control group, the average score of complaints was 2.72, SD +/- 0.7, and they also took drugs for the alleviation of their complaints more rarely. Conclusions. Nonsteroidal antiinflammatory drugs belong among the important causes of dyspepsia in the elderly. When making decisions about the various diagnostic procedures for defining the etiology of dyspepsia, we must be guided by a good knowledge of the symptoms as well as of our patients. Izhodišča. Obravnava bolnikov z dispeptičnimi simptomi je diagnostični in terapevtski problem, s katerim se pogosto srečujejo zdravniki splošne in družinske medicine, internisti in gastroenetrologi. Namen raziskave. V raziskavi smo skušali ugotoviti izraženost in pogostost dispeptičnih simptomov pri bolnikih, starejših od 60 let, ki so redno uporabljali nesteroidna protivnetna zdravila. Bolniki in metode. Raziskava je prospektivna, kohortna, temelječa na intervjuju ambulantnega pregleda, rezultatih opravljenih diagnostičnih postopkov in sledenju. Potekala je v obdobju 1999-2003 v ambulanti družinske medicine in gastroenterološki ambulanti. Pri bolnikih, ki so redno uporabljali nesteroidna protivnetna zdravila, smo ugotavljali pogostost in izraženost dispeptičnih simptomov, najpogosteje uporabljana zdravila in rezultate diagnostičnih postopkov, ki smo jih opravili za opredelitev vzroka dispepsije. Kontrolno skupino so sestavljali bolniki, starejši od 60 leta, pri katerih so se prav tako pojavljali dispeptični simptomi, vendar niso uporabljali nesteroidnih protivnetnih sredstev. Rezultati. V raziskavo smo vključili 50 bolnikov, 27 žensk in 23 moških, povprečne starosti 67,3 leta, v razponu od 60-80 let, v kontrolni skupini je bilo 50 bolnikov, 28 žensk in 22 moških, povprečne starosti 66,6 let, v razponu od 61-80 let. Vsi bolniki študijske skupine so v obdobju zadnjih treh mesecev uporabljali NSAR ali pripravke acetilsalicilne kisline. Med bolniki obeh skupin ni bilo pomembnih razlik v številu in uporabi drugih zdravil, ki so jih uporabljali, p=0,65. Povprečna ocena dispeptičnih težav v študijski skupini je bila 3,02, SD +/- 0,6, med njimi je 70 % bolnikov želelo uporabljati antagoniste receptorjev H2, ali zaviralce protonske črpalke zaradi teh težav. Med bolniki kontrolne skupine je bila povprečna ocena izraženosti težav 2,72, SD +/- 0,7, redkeje so tudi posegali po zdravilih, ki naj bi jim olajšala njihove težave, le v 52 %. Razlika v izraženosti dispeptičnih težav je med obema skupinama statistično značilna, p=0,02. Zaključki. Nesteroidna protivnetna zdravila sodijo med pomembne vzroke dispepsije pri starostnikih. Odločitev o različnih diagnostičnih postopkih usmerjata dobro poznavanje simptomov in svojih bolnikov. |
