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Gastritis and dyspepsia: differentiation as the cornerstone of pharmacotherapy

https://doi.org/10.21518/ms2023-137

Abstract

Chronic gastritis is a complex, polyetiological pathology with no clear clinical presentation. The most significant etiological factor of gastritis to date is H. pylori infection. A common clinical manifestation is the dyspepsia syndrome, which is caused by impaired motility. Symptoms can significantly affect a patient’s quality of life, necessitating rapid and effective pharmacotherapy. This paper discusses the algorithm of the physician actions in the case of a patient with uninvestigated dyspepsia. PPI has significant negative impact on the accuracy of H. pylori diagnostic test results. In this regard, it is proposed to use empirical therapy with prokinetics before diagnostic test would be performed. Among the prokinetics available on the Russian market, itopride hydrochloride stands out due to its high safety profile and proven efficacy. Current evidence supports the use of the prokinetic Ganaton® (itopride hydrochloride) as empirical therapy for dyspepsia of undetermined etiology, including patients with a preliminary diagnosis of gastritis. Due to its dual mechanism of action, itopride hydrochloride alleviates dyspeptic symptoms by improving gastric evacuation and can be used for an extended period. Several studies have shown the superiority of itopride in treating functional dyspepsia compared to other prokinetics, including metoclopramide and domperidone. Thus, prescribing the prokinetic Ganaton® (itopride hydrochloride) as empirical therapy for dyspepsia of undetermined etiology, including patients with a preliminary diagnosis of gastritis, is a pathogenetically justified approach aimed at improving the patient’s condition in the short term before establishing a final clinical diagnosis.

About the Authors

D. S. Bordin
Loginov Moscow Clinical Scientific Center; Yevdokimov Moscow State University of Medicine and Dentistry; Tver State Medical University
Russian Federation

Dmitry S. Bordin, Dr. Sci. (Med.), Head of the Department of Pathology of the Pancreas, Biliary Tract and Upper Digestive Tract; Professor of the Department of Propaedeutics of Internal Diseases and Gastroenterology; Professor of the Department of General Medical Practice and Family Medicine 

86, Entuziastov Shosse, Moscow, 111123;
20, Bldg. 1, Delegatskaya St., Moscow, 127473;
4, Sovetskaya St., Tver, 170100



M. А. Livzan
Omsk State Medical University
Russian Federation

Maria А. Livzan, Сorr. Member RAS, Dr. Sci. (Med.), Professor, Gastroenterologist, Chief Freelance Therapist of the Ministry of Health of Russia for the Siberian Federal District, Head of the Department of Faculty Therapy and Gastroenterology, Rector 

12, Lenin St., Omsk, 644043



Y. А. Kucheryavyy
Ilyinskaya Hospital JSC
Russian Federation

Yury А. Kucheryavyy, Cand. Sci. (Med.), Leading Gastroenterologist 

2, Bldg. 2, Urban District Krasnogorsk, Village Glukhovo, Rublevskoe Predmestʹe St., 143421



S. I. Mozgovoi
Omsk State Medical University
Russian Federation

Sergei I. Mozgovoi, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Pathological Anatomy 

12, Lenin St., Omsk, 644043



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For citations:


Bordin DS, Livzan MА, Kucheryavyy YА, Mozgovoi SI. Gastritis and dyspepsia: differentiation as the cornerstone of pharmacotherapy. Meditsinskiy sovet = Medical Council. 2023;(8):77-86. (In Russ.) https://doi.org/10.21518/ms2023-137

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)