Dispepsia
Dispepsia Riki TenggaraPENDAHULUANDyspepsia berasal dari bahasa
Yunani yaitu dys ("bad") and peptein ("digestion").
didefinisikan sebagai nyeri persisten atau berulang atau
ketidaknyamanan berpusat di perut bagian atas.Berdasarkan pendapat
konsensus panel peneliti internasionalOr
indigestionPENDAHULUANUninvestigated dyspesiaAda kelainan
organikInvestigated dyspepiaDyspepsiaTidak ada kelainan organikExp:
gastric ulcerDispepsia fungsionalEPIDEMIOLOGI20-40 % orang dewasa
yang datang ke bag.Gastroenterologi dengan keluhan DISPEPSIASEKRESI
ASAM LAMBUNG
PATOFISIOLOGI DISPEPSIA
PATOFISIOLOGI DISPEPSIAHipotesis : asam lambung =
dispepsiaHipotesis : disfungsi motorik = dispepsia sekresi asam
lambung Stimulasi labung terhadap gastrin releasing peptide
Sensitivitas viseral terhadap as.lambungPerubahan sekresi dan
respon terhadap sekretin dan kolesistokininTeori dispepsi8Rome III
Diagnostic Criteria for FGIDB1. FUNCTIONAL DYSPEPSIADiagnostic
criteria* Must include:2. No evidence of structural disease
(including at upper endoscopy) that is likely to explain the
symptoms* Criteria fulfilled for the last 3 months with symptom
onset at least 6 months prior to diagnosis1. One or more of the
following:a. Bothersome postprandial fullnessb. Early satiationc.
Epigastric paind. Epigastric burning
B1a. Postprandial Distress SyndromeDiagnostic criteria* Must
include one or both of the following:Bothersome postprandial
fullness, occurring after ordinary-sized meals, at least several
times per weekEarly satiation that prevents finishing a regular
meal, at least several times per week* Criteria fulfilled for the
last 3 months with symptom onset at least 6 months prior to
diagnosisRome III Diagnostic Criteria for FGID(2)Supportive
criteriaUpper abdominal bloating or postprandial nausea or
excessive belching can be presentEpigastric pain syndrome may
coexistRome III Diagnostic Criteria for FGID(3)B1b. Epigastric Pain
SyndromeDiagnostic criteria* Must include all of the following:Pain
or burning localized to the epigastrium of at least moderate
severity, at least once per weekThe pain is intermittentNot
generalized or localized to other abdominal or chest regionsNot
relieved by defecation or passage of flatusNot fulfilling criteria
for gallbladder and sphincter of Oddi disorders* Criteria fulfilled
for the last 3 months with symptom onset at least 6 months prior to
diagnosisSupportive criteriaThe pain may be of a burning quality,
but without a retrosternal componentThe pain is commonly induced or
relieved by ingestion of a meal, but may occur while
fastingPostprandial distress syndrome may coexistDIAGNOSIS
BANDINGPenyakit GERDUlkus peptikumBerkaitan dengan obat-obatan :
OAINS, Antibiotik, pre parat besi, kalium, digoksinMalabsorpsi
karbohidratKolelitiasis dan koledokolitiasisPankreatitis
kronikPenyakit sistemik( DM, Ggn hormon tiroid)Investasi
cacingKeganaan abdomenIskemia kronik pada pembuluh darah arteri
mesenterikaPEMERIKSAAN PENUNJANGENDOSKOPIGASTRIC EMPTYING
TIMEUSGENDOSKOPI ULTRASONOGRAFIELEKTROGASTROGRAFIMANOMETRI
ANTRO-DUONEALProses Mencerna(indigestion)Penyebab
lainJantungHatiKantong empeduPankreasIntestineOAINS
dllDISPEPSIAPredominanHeartburnKelolaSebagai GERDTanda
bahaya/alarmDisfagiaPerdarahan sal.cerna Muntah
terus-menerusPancreasBB Masa abnomen bag.atasRujuk ke RS u/
endoskopiDispepsia tanpa komplikasiPertimbanganModifikasi gaya
hidupantasidaDispepsia tanpa komplikasiPertimbanganModifikasi gaya
hidupantasidaTes H.pyloricTes Hp PositifTes Hp
NegatifEradikasiAsimtomatikSimtom yang menetap/kambuhUmurKelola
sebagai fungsional dispepsiaRujuk ke RS dengan fasilitas
endoskopiGejala menetap/kambuh55 tahun
PENATALAKSANAAN16
PENATALAKSANAAN(2)Nature Reviews Gastroenterology &
Hepatology10,187-194(March 2013)PENATALAKSANAAN(3)
Dyspepsia: management of dyspepsia in adults in primary care.
London: NICE. 2004Thank you
