Overview
It refers to a cluster of dyspeptic symptoms such as postprandial fullness and early satiety and is a clinical subtype of functional dyspepsia.
Causes
1. The disorder of gastric fundus tolerance and diastole after eating, the disorder of coordination of gastric sinus duodenal movement and visceral hypersensitivity, and other factors.
2. Psychological, environmental and social factors.
Symptoms
Early satiety, postprandial epigastric fullness and discomfort, aggravated after eating greasy food, may be accompanied by nausea, vomiting and excessive belching. Symptoms are mostly intermittent, and only 1/3 of patients can disappear on their own. This syndrome coexists with epigastric pain syndrome. Most patients have a tendency towards psychosomatic abnormalities.
Examination
The purpose of examination is to exclude organic lesions of the digestive tract, liver, biliary tract, pancreas, spleen and kidney.
1. Laboratory examination
Blood, urine and stool routine; liver and kidney function, biochemical routine, blood sedimentation and so on.
2. Imaging examination
Ultrasound, X-ray, CT, MRI, etc.
3.Endoscopy
Diagnosis
1. Confirmation of the diagnosis must include at least 1 of the following items
(1) discomfort of fullness after ordinary meals, at least 3 days a week.
(2) Early satiety, i.e., inability to finish eating the usual meal size, at least 3 days per week.
The duration of the disease is at least 6 months, and the condition has met the above diagnostic criteria in the last 3 months.
2. Conditions supporting the diagnosis
(1) Epigastric distension or postprandial nausea, excessive belching.
(2) May coexist with epigastric pain syndrome.
Treatment
Mainly symptomatic treatment, follow the principle of comprehensive treatment and individualized treatment.
1. General treatment
Establish good living habits, avoid smoking, alcohol and non-steroidal anti-inflammatory drugs. No special recipes, avoiding foods that induce symptoms in personal life experiences. Pay attention to psychological treatment according to different characteristics of patients. Insomnia, anxiety can be appropriately sedative, anti-anxiety drugs.
2. Medication
There is no specific drug, mainly empirical drug treatment.
(1) Inhibition of gastric acid secretion drugs are generally used for patients with abdominal pain as the main symptom, and H2 receptor antagonists or proton pump inhibitors can be used selectively.
(2) Gastrointestinal stimulants Generally used in patients with epigastric distension, early satiety and belching as the main symptoms. Selectively take domperidone, mosapride, itopride and so on.
(3) Eradication of Helicobacter pylori treatment Eradication treatment is needed for patients with Helicobacter pylori infection.
(4) Antidepressants and anxiolytics The above treatments are ineffective and accompanied by obvious mental symptoms can be tried, commonly used tricyclic antidepressants; selective inhibition of 5-hydroxytryptamine reuptake agents, haloperidol melittin tablets, etc., it is advisable to start with a small dose, pay attention to the adverse effects of the drug. It is recommended to take them under the guidance of specialized physicians.
(5) Others: Gastric mucosal protective agents, such as aluminum hydroxide gel, bismuth, aluminum thiosulfate, methysergide-S and so on. It can also be treated with traditional Chinese medicine.
Questions you may be concerned about
Postprandial discomfort syndrome
Postprandial discomfort syndrome should be treated with either medication or surgery, depending on the specific triggers. If it is caused by functional dyspepsia, it is recommended to choose medication; if it is caused by organic gastrointestinal pathology, it usually requires surgical treatment.
Postprandial discomfort syndrome refers to a cluster of dyspeptic symptoms such as postprandial fullness and early satiety. Different treatments can be chosen according to different triggers, as follows:
1. Pharmacological treatment: the main application of prokinetic agents, such as Itopride, through the dual mechanism of acetylcholinesterase inhibitors and dopamine receptor antagonists, has a better therapeutic effect on postprandial discomfort syndrome caused by functional dyspepsia. Meanwhile, antidepressant and anxiolytic drugs, such as buspirone and tandospirone, are also needed to improve the postprandial discomfort syndrome.
2. Surgery: If postprandial discomfort syndrome is diagnosed to be caused by organic gastrointestinal lesions, such as gastric cancer, corresponding surgery is needed to treat it, and gastric cancer patients usually need to undergo gastrectomy.
Postprandial discomfort syndrome should be taken seriously, and the patient should go to regular hospitals as early as possible for consultation, so as to clearly diagnose the specific triggers, and then under the guidance of doctors for symptomatic treatment.