Dyspepsia history and symptoms: Difference between revisions
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== | ==Overview== | ||
The history and [[symptoms]] of dyspepsia are [[pain]] or a burning feeling in the upper portion of the [[stomach]], [[nausea]], [[bloating]], sometimes uncontrollable [[burping]], [[heartburn]], [[fever]], [[metallic taste]], rumbling in the [[stomach]], sense of [[Fullness after a meal|fullness after eating]], feeling as though something is lodged in the [[esophagus]], [[pain]] and discomfort at the [[Xiphoid process|xiphoid]] region, sudden [[chills]], comparable to those felt during [[fevers]]. | |||
== | ==History== | ||
Obtaining the history is the most important aspect of making a [[diagnosis]] of [[peptic ulcer disease|dyspepsia]]. It provides insight into the [[Causality|cause]], precipitating factors and associated [[comorbid]] conditions. | |||
===Past medical history=== | |||
*A history of [[epigastric pain]], [[dyspepsia]], or prior [[peptic ulcer]] may suggest the [[Diagnosis-related group|diagnosis]] of [[peptic ulcer disease|dyspepsia]].<ref name="LaineSolomon2016">{{cite journal|last1=Laine|first1=Loren|last2=Solomon|first2=Caren G.|title=Upper Gastrointestinal Bleeding Due to a Peptic Ulcer|journal=New England Journal of Medicine|volume=374|issue=24|year=2016|pages=2367–2376|issn=0028-4793|doi=10.1056/NEJMcp1514257}}</ref><ref name="pmid17956071">{{cite journal| author=Ramakrishnan K, Salinas RC| title=Peptic ulcer disease. | journal=Am Fam Physician | year= 2007 | volume= 76 | issue= 7 | pages= 1005-12 | pmid=17956071 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17956071 }} </ref><ref name="pmid28798512">{{cite journal| author=Drini M| title=Peptic ulcer disease and non-steroidal anti-inflammatory drugs. | journal=Aust Prescr | year= 2017 | volume= 40 | issue= 3 | pages= 91-93 | pmid=28798512 | doi=10.18773/austprescr.2017.037 | pmc=5478398 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28798512 }} </ref> | |||
===Medication history=== | |||
*Prior use of [[aspirin]] or [[Non-steroidal anti-inflammatory drug|nonsteroidal anti-inflammatory drugs]] ([[Non-steroidal anti-inflammatory drug|NSAIDs]]) is important because these patients have an increased risk of [[gastric ulcer]] and a fourfold risk of significant [[Gastrointestinal tract|GI]] [[bleeding]] compared with other patients<ref name="pmid5303551">{{cite journal |vauthors=Goulston K, Cooke AR |title=Alcohol, aspirin, and gastrointestinal bleeding |journal=Br Med J |volume=4 |issue=5632 |pages=664–5 |year=1968 |pmid=5303551 |pmc=1912769 |doi= |url=}}</ref> | |||
===Social history=== | |||
*[[Helicobacter pylori infection]] is more common in low socioeconomic status and increased number of siblings<ref name="pmid18783514">{{cite journal |vauthors=Bruce MG, Maaroos HI |title=Epidemiology of Helicobacter pylori infection |journal=Helicobacter |volume=13 Suppl 1 |issue= |pages=1–6 |year=2008 |pmid=18783514 |doi=10.1111/j.1523-5378.2008.00631.x |url=}}</ref> | |||
*[[Alcoholic|Alcoholics]] also frequently have [[peptic ulcers]] or [[gastritis]]<ref name="pmid2226291">{{cite journal |vauthors=MacMath TL |title=Alcohol and gastrointestinal bleeding |journal=Emerg. Med. Clin. North Am. |volume=8 |issue=4 |pages=859–72 |year=1990 |pmid=2226291 |doi= |url=}}</ref><ref name="pmid5303551" /> | |||
*[[Cigarette smoke|Cigarette smokers]] have a significantly higher rate of the recurrent [[duodenal ulcer]] as compared with nonsmokers <ref name="pmid28839832">{{cite journal |vauthors=Jafar W, Jafar AJN, Sharma A |title=Upper gastrointestinal haemorrhage: an update |journal=Frontline Gastroenterol |volume=7 |issue=1 |pages=32–40 |year=2016 |pmid=28839832 |pmc=5369541 |doi=10.1136/flgastro-2014-100492 |url=}}</ref><ref name="pmid17942452">{{cite journal |vauthors=Palmer K |title=Acute upper gastrointestinal haemorrhage |journal=Br. Med. Bull. |volume=83 |issue= |pages=307–24 |year=2007 |pmid=17942452 |doi=10.1093/bmb/ldm023 |url=}}</ref> | |||
===Family history=== | |||
*[[Family history]] of [[peptic ulcer disease|dyspepsia]] increases the risk of [[peptic ulcer]] | |||
*History of [[peptic ulcer disease|dyspepsia]] in mother increases the risk of [[peptic ulcer disease|dyspepsia]] in [[children]] | |||
== Symptoms == | |||
*The majority of patients with the [[peptic ulcer disease|dyspepsia]] are symptomatic but some people do not show any [[symptoms]] (silent [[ulcer]]). | |||
*The hallmark of [[peptic ulcer disease|dyspepsia]]: | |||
**Episodic gnawing or burning [[epigastric pain]] which occurs one to five hours after meals or on an empty [[stomach]] | |||
**Nocturnal [[pain]] relieved by [[food]] intake, [[Antacid|antacids]], or antisecretory agents<ref name="pmid17956071" /> | |||
**Chronic use of [[NSAIDs]] | |||
===Common symptoms=== | |||
Common [[symptoms]] of [[peptic ulcer disease|dyspepsia]] include: | |||
*Episodic [[epigastric pain]] | |||
*[[Heartburn]] | |||
*[[Bloating]] | |||
*[[Nausea and vomiting]] | |||
*Waterbrash | |||
*[[Indigestion]] | |||
*[[Hematemesis]] | |||
*[[Melena]] | |||
*[[Loss of appetite]] | |||
===Less common symptoms=== | |||
Less common [[symptoms]] of dyspepsia include: | |||
*Intolerance to fatty food | |||
==References== | |||
{{Reflist|2}} | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Gastroenterology]] | |||
Latest revision as of 21:30, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ajay Gade MD[2]]
Overview
The history and symptoms of dyspepsia are pain or a burning feeling in the upper portion of the stomach, nausea, bloating, sometimes uncontrollable burping, heartburn, fever, metallic taste, rumbling in the stomach, sense of fullness after eating, feeling as though something is lodged in the esophagus, pain and discomfort at the xiphoid region, sudden chills, comparable to those felt during fevers.
History
Obtaining the history is the most important aspect of making a diagnosis of dyspepsia. It provides insight into the cause, precipitating factors and associated comorbid conditions.
Past medical history
- A history of epigastric pain, dyspepsia, or prior peptic ulcer may suggest the diagnosis of dyspepsia.[1][2][3]
Medication history
- Prior use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) is important because these patients have an increased risk of gastric ulcer and a fourfold risk of significant GI bleeding compared with other patients[4]
Social history
- Helicobacter pylori infection is more common in low socioeconomic status and increased number of siblings[5]
- Alcoholics also frequently have peptic ulcers or gastritis[6][4]
- Cigarette smokers have a significantly higher rate of the recurrent duodenal ulcer as compared with nonsmokers [7][8]
Family history
- Family history of dyspepsia increases the risk of peptic ulcer
- History of dyspepsia in mother increases the risk of dyspepsia in children
Symptoms
- The majority of patients with the dyspepsia are symptomatic but some people do not show any symptoms (silent ulcer).
- The hallmark of dyspepsia:
Common symptoms
Common symptoms of dyspepsia include:
- Episodic epigastric pain
- Heartburn
- Bloating
- Nausea and vomiting
- Waterbrash
- Indigestion
- Hematemesis
- Melena
- Loss of appetite
Less common symptoms
Less common symptoms of dyspepsia include:
- Intolerance to fatty food
References
- ↑ Laine, Loren; Solomon, Caren G. (2016). "Upper Gastrointestinal Bleeding Due to a Peptic Ulcer". New England Journal of Medicine. 374 (24): 2367–2376. doi:10.1056/NEJMcp1514257. ISSN 0028-4793.
- ↑ 2.0 2.1 Ramakrishnan K, Salinas RC (2007). "Peptic ulcer disease". Am Fam Physician. 76 (7): 1005–12. PMID 17956071.
- ↑ Drini M (2017). "Peptic ulcer disease and non-steroidal anti-inflammatory drugs". Aust Prescr. 40 (3): 91–93. doi:10.18773/austprescr.2017.037. PMC 5478398. PMID 28798512.
- ↑ 4.0 4.1 Goulston K, Cooke AR (1968). "Alcohol, aspirin, and gastrointestinal bleeding". Br Med J. 4 (5632): 664–5. PMC 1912769. PMID 5303551.
- ↑ Bruce MG, Maaroos HI (2008). "Epidemiology of Helicobacter pylori infection". Helicobacter. 13 Suppl 1: 1–6. doi:10.1111/j.1523-5378.2008.00631.x. PMID 18783514.
- ↑ MacMath TL (1990). "Alcohol and gastrointestinal bleeding". Emerg. Med. Clin. North Am. 8 (4): 859–72. PMID 2226291.
- ↑ Jafar W, Jafar A, Sharma A (2016). "Upper gastrointestinal haemorrhage: an update". Frontline Gastroenterol. 7 (1): 32–40. doi:10.1136/flgastro-2014-100492. PMC 5369541. PMID 28839832. Vancouver style error: initials (help)
- ↑ Palmer K (2007). "Acute upper gastrointestinal haemorrhage". Br. Med. Bull. 83: 307–24. doi:10.1093/bmb/ldm023. PMID 17942452.