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Dyspepsispatienten i almen praksis

Dyspepsispatienten i almen praksis. Læge ph.d. Jon Eik Zwisler. Ekspeditionskontor?. 3-5% af alle konsultationer Mere end 95% af medicin Langtidsbrug Gastroskopi er hyppig ved dyspepsi - men oftest normal Mange forskellige og vigtige årsager til dyspepsi. Dyspepsi i praksis.

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Dyspepsispatienten i almen praksis

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  1. Dyspepsispatienten i almen praksis Læge ph.d. Jon Eik Zwisler

  2. Ekspeditionskontor? • 3-5% af alle konsultationer • Mere end 95% af medicin • Langtidsbrug • Gastroskopi er hyppig ved dyspepsi - men oftest normal • Mange forskellige og vigtige årsager til dyspepsi

  3. Dyspepsi i praksis • Faresignaler? • Alder? • Tidligere • Skopi? • Dyspepsi-medicin? • Helicobacter-test? • Andet?

  4. Gastro-oesophageal refluks sygdom Dyspepsi Sure opstød og hals-brand dominerende symptomer Dyspepsi Refluks

  5. Udredningsstrategier • Gastroskopi? • Helicobacter pylori test? • Syrehæmmende behandling? • Se forløbet an?

  6. Dyspepsiudredning i praksis 417 randomly selected primary care physicians from 29 countries • Empirical treatment: 66.1% (range: 50-81%) • Test and treat strategy: 13.2% (range: 5-25%) • Endoscopy 17.9% (range: 4-24%) Huang, J Gastroenterol.Hepatol 2003

  7. Brug af medicin

  8. Hvem bruger syrehæmmende medicin? Lassen et al, Aliment pharmacol and therapeut 2004, 20 (5)

  9. Helicobacter pylori test Fordele: Patienter med Helicobacter pylori-positive ulcus behandles. Ulemper: Helicobacter pylori-positive uden ulcus har kun ringe gavn af behandling.

  10. Test-and-treat i praksis • Test: Helicobacter pylori test i praksis • Treat: Eradikationsbehandling og evt. kontrol i praksis.

  11. Mulighed for optimering • Helicobacter pylori-test • Medicinkontrol og patientvejledning • NSAID og ulcusygdom

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