教員業績データベース |
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論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読あり |
表題 | Evidence-based clinical practice guidelines for functional dyspepsia. |
掲載誌名 | 正式名:Journal of gastroenterology 略 称:J Gastroenterol ISSNコード:1435-5922(Electronic)0944-1174(Linking) |
巻・号・頁 | 50(2),pp.125-39 |
著者・共著者 | Miwa Hiroto, Kusano Motoyasu, Arisawa Tomiyasu, Oshima Tadayuki, Kato Mototsugu, Joh Takashi, Suzuki Hidekazu, Tominaga Kazunari, Nakada Koji, Nagahara Akihito, Futagami Seiji, Manabe Noriaki, Inui Akio, Haruma Ken, Higuchi Kazuhide, Yakabi Koji, Hongo Michio, Uemura Naomi, Kinoshita Yoshikazu, Sugano Kentaro, Shimosegawa Tooru |
発行年月 | 2015/01 |
概要 | UNASSIGNED:General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the woUNASSIGNED:rld's first country to listUNASSIGNED:"UNASSIGNED:functional dyspepsiaUNASSIGNED:"UNASSIGNED:as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment. |
DOI | 10.1007/s00535-014-1022-3 |
PMID | 25586651 |