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    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.

      1. Lazebnik L. B., Alekseenko S. A., Lyalykova E. A., Samsonov A. A. et al. Recommendations on management of primary care patients with symptoms of dyspepsia. Experimental and Clinical Gastroenterology. 2018;153(5):04–18.
      2. Ivashkin V. T., Mayev Y. A. et al. Clinical recommendations of RGA for the diagnosis and treatment of infection HP in adults. Russian journal of Gastroenterollogy, Hepatology, Coloproctology. 2018; Vol. 28 (1): 55–70.
      3. Order of the Ministry of health of the Russian Federation of 22.11.2004 № 248 "On approval of the standard of medical help patients with chronic gastritis, duodenitis, the dyspepsia" ( doc8484.html, appeal 31.10.2018).
      4. Kareva E. N., Serebrova S. Yu. Challenges in drug treatment of gastric motility disorders. Experimental and Clinical Gastroenterology. 2017;143(07):167–183.
      5. Ivashkin V. T., Mayev I. V., Sheptulin A. A. et al. Clinical recommendations of the Russian gastroenterological Association for diagnosis and treatment functional dyspepsia. Russian journal of Gastroenterology, Hepatology, Coloproctology. 2017; Vol. 27(1): 50–61.
      6. Sugano K., Tack J., Kuipers E. J., et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut 2015 – Vol.64 – Р. 1353–67.
      7. Malfertheiner P, Megraud F, O’Morain C, et al. Management of Helicobacter pylori infection– the Maastricht V / Florence Consensus. Report. Gut – 2017 – Vol.66, № 1– Р. 6–30.
      8. Suzuki H., Moayyedi P. Helicobacter pylori infection in functional dyspepsia. Nat. Rev. Gastroenterol. Hepatol. – 2013 – № 10 – Р. 168–74.
      9. Mazzoleni L.E., Sander G. B., Francesconi C. F., et al. Helicobacter pylori eradication in functional dyspepsia: heroes trial. Arch. Intern. Med. – 2011 – Vol.171 – Р. 1929–36.
      10. Marakhovskii K. Yu., Vasilevskaya S. A., Karasev G. A. et al. Gastroesophageal refl ux disease: comparative evaluation of the effi cacy and safety of omeprazole in combination with domperidone in comparison with omeprazole. Lechebnoe delo. 2015; 2: 7–16.
      11. Krapivnaya O. V., Alekseenko S. A. Gastroesophageal refl ux disease in patients with functional dyspepsia and constipation predominant irritable bowel syndrome: clinical features and effi cacy of lactulose and itopride hydrochloride. Almanac of clinical medicine.2014; 33: 57–63.
      12. Ohara S., Kawano Т., Kusano M., Kouzu T. Survey on the prevalence of GERD and FD based on the Montreal defi nition and the Rome III criteria among patients presenting with epigastric symptoms in Japan. J Gastroenterol – 2011 – Vol. 46, № 5 – P. 603–11.
      13. Tack J., Caenepeel P., Arts J. et al. Prevalence of acid refl ux in functional dyspepsia and its association with symptom profi le. Gut. – 2005. – Vol. 54, № 10 – P. 1370–76.
      14. Keohane J, Quigley EM. Functional dyspepsia and nonerosive refl ux disease: clinical interactions and their implications. Med Gen Med. –2007– Vol. 9, № 3–31.
      15. Lazebnik L. B., Masharova A. A., Bordin D. S. et al. Results of a multicenter trial "Epidemiology of Gastroesophageal Refl ux Disease in Russia" (MEGRE). Ter Arkh. 2011; 83(1): 45–50.
      16. Sablin O. A., Ledovskaya A. A. New features of antisecretory therapy of gastroesophageal refl ux disease. Experimental and clinical gastroenterology. 2012; no.8: 98–101.

    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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