Isi:
1. Pendahuluan
2. Definisi
3. Klasifikasi
4. Epidemiologi
5. Patogenesis
6. Gambaran Klinik
7. Pendekatan Diagnosis
8. Diferensial Diagnosis
9. Pengobatan
10. Prognosis
11. Kesimpulan
Dyspepsia berasal dari bahasa Yunani:
Dys = Bad
Pepsis = Digestion
Dispepsia:
Bukan suatu penyakit tapi merupakan suatu kumpulan gejala yang harus
dicari penyebabnya.
Dispepsia:
organik (40%): ada lesi struktural mukosa gastroduodenum
fungsional (60%): tidak ditemukan lesi struktural mukosa
gastroduodenum
Dyspepsia (Rome II): Perasaan tidak nyaman di daerah
epigastrium
Diagnostic Criteria (Rome II):
At least 12 weeks, which need not be consecutive, in the preceding
12 months of:
1) Persistent or recurrent dyspepsia
2) No evidence of organic disease that is likely to explain symptoms; and
3) No evidence that dyspepsia is exclusively relieved by defecation or
associated with onset of a change in stool frequency or form (not irritable
bowel).
Rome III- similar to Rome II but now FD is broken down into two
subgroups based on a complex of symptom features:
1) Postprandial distress syndrome
2) Epigastric pain syndrome
Banyak penyakit yang dapat menyebabkan sindroma dyspepsia
Secara garis besar dibagi:
▪ Organik dan Fungsional
Organik: 40%
ulkus peptikum, tumor gastrointestinal, Kronik intestinal ischemia, penyakit-
penyakit pankreatikobilier, akibat obat-obatan termasuk NSAID gastropathy
Fungsional: 60%
Bila dispepsia organik telah disingkirkan
Konsensus Rome II menetapkan symptom based diagnostic criteria dengan 3
subtype: Ulcer-like dyspepsia, Dysmotility-like dyspepsia dan unspecified (non-
spesifik dyspepsia)
Konsensus Rome III: merevisi Rome II menjadi 2 subtype yaitu post prandial distress
syndrome dan epigastric pain syndrome
Prevalensi Dyspepsia +/- 25% dengan variasi 3-
15% bila GERD dikeluarkan
Prevalensi uninvestigated +/- 40%
Incidence Dyspepsia +/- 10% dengan kasus baru
5-7% di primary care visit
Symptom Dyspepsia 40-70% dari keluhan-
keluhan gastrointestinal yang berobat pada
general gastroenterology
Patogenesis dari dyspepsia organik tergantung
dari penyakit organik yang mendasarinya
Functional dyspepsia
+ -
Eradicate
Trial of acid suppression Trial of prokinetic medication
Ulcer-like Dysmotility-like
Education/lifestyle modification
Test Hp
+ -
Success Failure
Investigate Trial of prokinetic
Dysmotility-like Symptoms Dominant
Educate/lifestyle modification
Trial of prokinetic
medication
Success Failure
Eradicate
Consider H2
Success Failure antagonists, tricyclics
Small frequent meals
Stop smoking
Reduce alcohol
Reduce caffeine
Avoid irritating foodstuffs
Maintain an ideal weight
Review medications
Patient anxiety or irrational fears
Limited data
Improvement in psychological well-being index but lack of
durability 1
RCT showed prompt endoscopy led to greater patient
satisfaction compared with empiric H2RA therapy2
Biased by patient expectation
Alternate
PPI - BMT BID Bismuth 2 tabs qid
Metronidazole 250 mg qid
Tetracycline 500 mg qid
Dyspepsia fungsional yang ditegakan setelah
pemeriksaan klinis dan penunjang yang
akurat mempunyai prognosis yang baik