Title Refrakterna dispepsija kao klinički problem Title (english) Refractory dyspepsia as a clinical problem Author Barbara Medić Mentor Žarko Babić (mentor)Committee member Neven Ljubičić (predsjednik povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Žarko Babić (član povjerenstva)Granter University of Zagreb Defense date and country 2019-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Dispepsija je poremećaj kojeg obilježavaju dispeptički simptomi kao što su bolovi u žličici, mučnina, povraćanje, nadutost i žgaravica. Kod funkcijske dispepsije (FD), za razliku od organske dispepsije, ne postoji organski uzrok koji bi doveo do nastanka simptoma. Pacijenti s FD-om prema Rimskim kriterijima IV dijele se u tri podskupine. Prva podskupina su pacijenti s epigastričnim sindromom boli (EPS). Druga podskupina su pacijenti s postprandijalnim distresnim sindromom (PDS), a u trećoj podskupini se preklapaju i EPS i PDS. Postoji više patofizioloških mehanizama kojima se pokušava objasniti zašto dolazi do poremećaja. Najvažniji su promjena motoričke aktivnosti želuca, imunološke i promjene funkcije sluznice te sastava mikrobiote, visceralna hiperosjetljivost i drugačija obrada informacija u središnjem živčanom sustavu. FD je jedan od češćih poremećaja probavnog sustava. Novija istraživanja upućuju da kod dijela pacijenata nakon preboljelog gastroenteritisa zaostane upala duodenalne sluznice koja dovodi do poremećaja gastrointestinalnog motiliteta i funkcije. Ne postoji jedinstven test, već se dijagnoza FD-e postavlja na temelju anamneze, kliničke slike i isključenjem ostalih bolesti koje se mogu prezentirati dispeptičkim simptomima. Prva terapijska linija je eradikacija Helicobacter pylori infekcije kod pacijenata koji su pozitivni. Ostali lijekovi koji se koriste u terapiji su inhibitori protonske pumpe, prokinetici i neuromodulatori te neki biljni lijekovi. Ti lijekovi kod dijela pacijenata uspješno ublažavaju bolove, mučninu, nadutost i žgaravicu. Kod dijela pacijenata ne dolazi do smanjenja intenziteta simptoma unatoč primjeni terapije i najčešće im je teško narušena kvaliteta života. Zbog velike prevalencije FD-e, daljnja istraživanja usmjerena su na pronalazak točnog patofiziološkog mehanizma, a time i lijekova koji bi pacijente oslobodili svih tegoba.
Abstract (english) Dyspepsia is a disorder characterized by dyspeptic symptoms such as epigastric pain, nausea, vomiting, bloating and heartburn. Unlike organic dyspepsia, in functional dyspepsia (FD), there is no organic cause of dyspeptic symptoms. According to the Rome Criteria IV, patients with FD can be divided into three subgroups. First subgroup encompasses patients with epigastric pain syndrome (EPS). Second subgroup encompasses patients with postprandial distress syndrome (PDS), and third subgroup encompassess patients with overlapping EPS and PDS traits. There are several underlying pathophysiological mechanisms of FD, but the most important are motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota and altered central nervous system processing. FD is one of the more common gastrointestinal disorder. Recent researches suggest that after overcoming gastroenteritis some patients deal with the inflammation of the duodenal mucosa which then leads to gastrointestinal motility and function disorders. Appropriate diagnostic marker for FD is not found. Diagnosis is based on clinical history, clinical presentation and exclusion of other organic disease which may present with dyspeptic symptoms. The first line treatment is eradication of Helicobacter pylori infection in Helicobacter pylori positive patients. Proton pump inhibitors, prokinetics, neuromodulators and some herbal remedies are also used in therapy. These drugs successfully relieve pain, nausea, bloating and heartburn in some patients. However, in some patients there is no reduction in the intensity of the symptoms despite the use of the therapy and their quality of life is often severely impaired. Due to the high prevalence FD further researches aim at finding a specific pathophysiological mechanisms and thus the remedies that would relieve the patients of all the problems.
Keywords
dispeptički simptomi
patofiziološki mehanizam
dijagnostika
terapija
Keywords (english)
dyspeptic symptoms
pathophysiological mechanism
diagnosis
therapy
Language croatian URN:NBN urn:nbn:hr:105:837633 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2019-11-20 15:50:33
