dyspepsia 4

Handling
Based on National Consensus Penanggulangan Helicobacter pylori in 1996, set handling dyspepsia scheme, which is differentiated for the health centers with experts (gastroenterolog or internist), along with the facilities with the endoscope handling dyspepsia in the community.
Medicine dyspepsia recognize some classes of drugs, namely:
1. Antacid 20-150 ml / day
The drug is easily obtained and inexpensive. Antacid netralisir sekresi stomach acid. Antacid usually contains Na bicarbonate, Al (OH) 3, Mg (OH) 2, and Mg triksilat. Giving antacid not ongoing, is only simtomatis, to reduce the pain. Mg triksilat can be used in a longer time, as well as nutritious as adsorben are nontoxic so, but in large doses may cause diarrhea due to form compound MgCl2.

2. Antikolinergik
Note, because this work is not specific drugs. Medicine that is quite selective pirenzepin work as anti reseptor muskarinik who can hit seksresi acid bounce around 28-43%. Pirenzepin also have the effect sitoprotektif.
3. Antagonise reseptor H2
The drug is widely used to treat dyspepsia such as organic or essential injure peptik. Drugs that include the antagonise receptor H2, among other simetidin, roksatidin, ranitidin, and famotidin.
4. Retarder pump acid (proton pump inhibitor PPI =)
The drug is set sekresi stomach acid on the final stages of the process sekresi acid stomach. Medicines that include the PPI is omeperazol, lansoprazol, and pantoprazol.
5. Sitoprotektif
Prostoglandin synthetic such as misoprostol (PGE1) and enprostil (PGE2). In addition to the sitoprotektif, also pressing sekresi stomach acid by parietal cells. Sukralfat work to improve sekresi prostoglandin endogen, which further improve mikrosirkulasi, mukus increase production and improve sekresi bicarbonate mucosa, and the Protective layer formed (protective site), a protein with compoud around lesi mukosa digested the top of the channel (SCBA).
6. Group prokinetik
Classes of drugs that includes this, that is sisaprid, domperidon, and metoklopramid. Group is quite effective to treat dispepsia functional and refluks esofagitis with refluks prevent and improve bersihan stomach acid (acid clearance).
7. Sometimes also required psikoterapi and psikofarmaka (anti-depression drugs and fear) in patients with dispepsia functional, because it is not uncommon complaint that appears related to factors such as the fear psychosis and depression
Treatment for patients farmakologis functional dispepsia not satisfactory. Results of research in general, controlled trials are still disappointing and only found a relatively small benefit of the placebo with histamin antagonis reseptor H2, resistor acid pumps (proton-pump inhibitors), and Helicobacter pylori eradication. Although a number of random research (randomized) controlled trials, and meta-analysis has shown the benefits of sisaprid compared to placebo, it is forbidden sisaprid purposes in most countries because it caused side effects on the heart.
In Japan, itoprid, which is a dopamin antagonis D2 prevent acetylcholinesterase work with, often prescribed for patients dispepsia functional. Although this drug has shown the ability to stimulate spontaneous movement (motality) side, the research that is designed exactly, random, controlled trials and to patient functional dispepsia weak. In Japan, itoprid prescribed to 50 mg three times a day. However, the response to the delivery of small doses should be seen from the other population.
Research conducted by Holtmann et al compare the functional dispepsia between patients who were given placebo and itoprid prescription. Functional dispepsia patients randomly to receive treatment itoprid (50.100, or 200 mg for three times a day) or placebo. After the eight week treatment, three main points efikasi analyzed: changes in the basic symptoms of the various functional dispepsia (as tested through the Leeds Dyspepsia Questionnaire), a global test of efikasi patients (the proportion of patients without signs or symptoms of increased symptoms), and a variety of aches and pain that counted in the five-level scale. After eight weeks, 41 percent of patients receiving placebo was free of symptoms, as a comparison with 57 percent, 59 percent, and 64 percent who received itoprid dose of 50, 100, 200 mg three times a day to (P <0:05 class="blsp-spelling-error" id="SPELLING_ERROR_104">oerbandingan between the placebo and itoprid)
Although the assessment of symptom-free siginifikan going on in the fourth group, the analysis reveal that the overall winner itoprid significantly more than placebo, with the value of symptom-free for groups of 100 and 200 mg (-6.24 and -6.27) versus (-4.50) for the placebo group; P = 0.05. Final and complete analysis shows that the value itoprid produce a better response than placebo (73 percent versus 63 percent, P = 0.04)