Italian guidelines for the diagnosis and treatment of functional dyspepsia - joint consensus from the Italian societies of gastroenterology and endoscopy (SIGE), Neurogastroenterology and motility (SINGEM), hospital gastroenterologists and endoscopists (AIGO), digestive endoscopy (SIED) and general medicine (SIMG)
Abstract
Functional dyspepsia (FD) is one of the most prevalent disorders of the upper gastrointestinal tract. Despite its broad prevalence, FD diagnosis and treatment are still not well standardized. The aim of this project was to outline an Italian Guideline to define a standardized approach in terms of diagnostic and therapeutic work-up to support both general practitioners and specialists in Gastroenterology. To address this issue, experts from 5 Italian Societies conducted a Delphi consensus process, which included a review of the current literature and voting process on 24 key statements. Recommendations and quality of evidence were evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Consensus for each statement was defined as ≥ 80 % agreement. DIAGNOSTIC APPROACH: The panel reached consensus on defining FD and its main symptoms and dividing this entity into two different subgroups: the epigastric pain syndrome (EPS) and the post-prandial distress syndrome (PDS). Consensus was reached on defining FD as a diagnosis of exclusion and on the need of performing an esophagogastroduodenoscopy with biopsies to exclude organic causes in patients 45 or older, in presence of alarm symptoms and/or in case of refractoriness to treatment. It was agreed that all patients should be screened for H. pylori infection (by invasive or non-invasive means) and that all HP-positive patients should receive eradication therapy. Routine blood tests…
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