Questão 18
Primary care physician should consider several factors when treating a patient who has dyspepsia. A patient’s age, symptoms, and past history should be taken into consideration. Patients with the onset of dyspepsia at age 55 or older or individuals with alarm symptoms at any age should undergo immediate upper endoscopy [28]. When HP is more common, testing and treatment remain the preferred strategies for patients younger than age 55. If the prevalence of HP infection in the community is less than 10%, a trial of a PPI is recommended. If that fail, a test for HP infection followed by eradication should be pursued if the test result is positive). Patients with reflux predominant symptoms should be treated as if they have gastroesophageal reflux disease. In this case, a trial with ranitidine is more cost-effective than omeprazole. If symptoms do not improved adequately, treatment to a PPI should be stepped up. There is no significant difference between equivalent doses of PPI. The decision to choose one over another should be based first on cost and second on individual patient response. If these strategies fail, upper endoscopy should be considered according to the clinician’s judgment. The prevalence of ilcer or malignancy in HP-negative patients is low in this group however. For patients who have functional dyspepsia that is negative for HP, normal endoscopy, and no response to an adequate trial of PPI, the clinician should re-evaluate the diagnosis.( Primary care: Clinics in Office Practice; 34(2007)99-108)
Com relação ao texto acima, assinale a opção mais correta:
Anterior
Próxima
Comentários