1. Siberian State Medical University of the Ministry of Healthcare of the Russia, Tomsk 634050, Russia
2. Federal State Autonomous Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of Russian Federation, Moscow, Russia

Keywords: recommendations, algorithm, dyspepsia, patient management tactics, proton pump inhibitor, prokinetics, primary care

Abstract:The aim. On clinical examples to demonstrate to the Therapist and General practitioner the possibility of using the roadmap of management of primary patients with symptoms of dyspepsia at the stage of outpatient care. Fundamentals. Clinical cases of patients with established diagnoses of Functional dyspepsia; Dyspepsia associated with Helicobacter pylori infection; Nonerosive refl ux disease; Gastroesophageal refl ux disease of I degree with nocturnal acid breakthroughs in combination with functional dyspepsia are presented. The questions of substantiation of preliminary and fi nal diagnoses, approaches of diff erential diagnosis of diseases using the road-map are considered in the comments. The main methods of diagnosis of diseases and disorders with symptoms of dyspepsia are presented and justifi ed. It is shown that prior to obtaining the results of esophagogastroduodenoscopy, a preliminary diagnosis Uninvestigated Dyspepsia “K 31.9 Disease of stomach and duodenum, unspecifi ed” should be made. After elimination of the organic cause of dyspepsia, treatment is carried out using proton pump inhibitors (omeprazole or rabeprazole 20 mg/day) in combination with a prokinetic (domperidone 30 mg/day). Rational use of a fi xed combination of omeprazole 20 mg with modifi ed release domperidone 30 mg / day (Omez®DSR). Conclusion. Compliance with the algorithm of management of primary patients with symptoms of dyspepsia in a wide clinical practice will avoid errors in the diagnosis, the appointment of unreasonable research, irrational treatment, which will improve the quality of life and prognosis of patients with dyspeptic disorders.

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Full text is published :
Dolgalev I. V., Drozdov V. N. Clinical examples to the algorithm on management of primary patients with symptoms of dyspepsia. Experimental and Clinical Gastroenterology. 2019;162(2): 165–172. (In Russ.) DOI: 10.31146/1682-8658-ecg-162-2-165-172
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