medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-7-44-51medsovet-6859Research ArticleЗаболевания пищевода и желудкаDiseases of the esophagus and stomachДиспепсия: терминология, причины и факторы риска, тактика ведения пациентовDyspepsia: terminology, causes and risk factors, patient managementhttps://orcid.org/0000-0001-9767-9619СюняеваЛ. А.SyunyaevaL. A.

Сюняева Лилия Абдулхаковна - клинический ординатор, кафедра пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119991, Москва, ул. Трубецкая, д. 8, стр. 2.

Liliya A. Syunyaeva - Resident Doctor, Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991.

mukhtarovaliliya@yandex.ruhttps://orcid.org/0000-0003-3628-2102ШульпековаН. В.ShulpekovaN. V.

Шульпекова Надежда Владимировна - клинический ординатор.

117036, Москва, ул. Дмитрия Ульянова, д. 11.

Nadezhda V. Shulpekova - Resident Doctor, National Medical Research Center for Endocrinology.

11, Dmitry Ulyanov St., Moscow, 117036.

nadshul@gmail.comhttps://orcid.org/0000-0003-4456-8725ЛапинаТ. Л.LapinaT. L.

Лапина Татьяна Львовна - кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119991, Москва, ул. Трубецкая, д. 8, стр. 2.

Tatiana L. Lapina - Cand. Sci. (Med.), Associate Professor, Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991.

lapina_t_l@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationНациональный медицинский исследовательский центр эндокринологииРоссияNational Medical Research Center for EndocrinologyRussian Federation202213052022074451Copyright © Сюняева Л.А., Шульпекова Н.В., Лапина Т.Л., 20222022Сюняева Л.А., Шульпекова Н.В., Лапина Т.Л.Syunyaeva L.A., Shulpekova N.V., Lapina T.L.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6859

Уточнение термина «диспепсия» связано с развитием представлений о функциональных заболеваниях желудочно-кишечного тракта (ЖКТ) и разработкой и внедрением Римских критериев этих заболеваний. Диспепсия – это комплекс симптомов, относящихся к гастродуоденальной области и включающий боль и чувство жжения в эпигастральной области, ощущение переполнения в эпигастрии после еды, раннее насыщение. Диспепсия широко распространена: около 20% взрослой популяции имеют данные симптомы. Важно отметить, что у большинства лиц с диспепсией (до 80%) с помощью традиционных диагностических методов органическая, системная или метаболическая причина симптомов не может быть идентифицирована, что свидетельствует о ее функциональной природе. У H. pylori-инфицированных пациентов с диспепсией симптомы могут быть связаны с гастритом в случае, если успешная эрадикация сопровождается устойчивой ремиссией (H. pylori-ассоциированная диспепсия). Если диспепсия сохраняется после этиологического лечения бактериального гастрита, следует поставить диагноз функциональной диспепсии. Особенностью функциональной диспепсии служат частый перекрест ее клинических вариантов (постпрандиальный дистресс-синдром – ППДС и синдром боли в эпигастрии – СБЭ) у одного пациента, а также частое сочетание с другими функциональными заболеваниями (например, синдром раздраженного кишечника – СРК) и гастроэзофагеальной рефлюксной болезнью (ГЭРБ). Для симптоматического лечения функциональной диспепсии назначают препараты различных групп: для подавления кислотной продукции желудка, прокинетики, селективные ингибиторы обратного захвата серотонина, трициклические антидепрессанты, а также новые для данного показания средства (H1-блокаторы, будесонид). Эффективность ингибиторов протонной помпы, в т. ч. в комбинации с прокинетиками, обладает высоким уровнем научной доказательности.

Clarification of the term dyspepsia is associated with the development of ideas about functional diseases of the gastrointestinal tract (GIT) and the development and implementation of the Rome criteria for these diseases. Dyspepsia is a complex of symptoms related to the gastroduodenal region and includes epigastric pain and burning sensation, epigastric fullness after eating, and early satiety. Dyspepsia is widespread, with about 20% of the adult population having these symptoms. It is important to note that in the majority of individuals with dyspepsia (up to 80%), the organic, systemic or metabolic cause of symptoms cannot be identified using traditional diagnostic methods, indicating its functional nature. In H. pylori-infected patients with dyspepsia, symptoms may be associated with gastritis if successful eradication is followed by sustained remission (H. pylori-associated dyspepsia). If dyspepsia persists after etiological treatment of bacterial gastritis, a diagnosis of functional dyspepsia should be established. A feature of functional dyspepsia is the frequent overlap of its clinical variants (postprandial distress syndrome (PPDS) and epigastric pain syndrome SBE) in one patient, as well as the frequent combination with other functional diseases (for example, irritable bowel syndrome (IBS)) and gastroesophageal reflux disease (GERD). For the symptomatic treatment of functional dyspepsia, drugs of various groups are prescribed: gastric acid supressants, prokinetics, selective serotonin reuptake inhibitors, tricyclic antidepressants, as well as new drugs for this indication (H1 blockers, budesonide). The effectiveness of proton pump inhibitors, including in combination with prokinetics, has a high level of scientific evidence.

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The authors declare that there are no conflicts of interest present.