小结
定义
病史和体格检查
关键诊断因素
- dor abdominal
- presença de fatores de risco
- "sinal de apontar"
其他诊断因素
- desconforto epigástrico
- náuseas ou vômitos
- saciedade precoce
- perda de peso ou anorexia
- diarreia
- sintomas de anemia
- hemorragia digestiva
- hipotensão ou choque séptico
- som de sucussão
危险因素
- infecção por Helicobacter pylori
- uso de anti-inflamatórios não esteroidais (AINEs)
- tabagismo
- idade mais avançada
- história pessoal de úlcera péptica
- história familiar de úlcera péptica
- paciente de terapia intensiva
- trabalho por turnos
Diagnostic tests
1st tests to order
- endoscopia digestiva alta
- Teste respiratório de ureia com carbono 13 para Helicobacter pylori ou teste de antígeno fecal
- Hemograma completo
Tests to consider
- nível de gastrina sérica em jejum
- exame de AINE na urina
Treatment algorithm
úlcera com sangramento ativo
sem sangramento ativo: Helicobacter pylori negativo
sem sangramento ativo: Helicobacter pylori positivo
úlceras recorrentes ou refratárias
Contributors
Expert advisers
Ian Beales, BSc, MD, FRCP, FEBG
Consultant Gastroenterologist
Clinical Associate Professor
Norwich Medical School
Department of Gastroenterology
Norfolk and Norwich University Hospital
Norwich
UK
Disclosures
IB declares that he has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:
Kristle Lee Lynch, MD
Assistant Professor of Clinical Medicine
Division of Gastroenterology
Department of Medicine
Hospital of the University of Pennsylvania
University of Pennsylvania
Perelman School of Medicine
Philadelphia
PA
Disclosures
KLL declares that she has no competing interests.
Peer reviewers
Alexander C Ford, MBChB, MD, FRCP
Professor of Gastroenterology
Honorary Consultant Gastroenterologist
Leeds Institute of Medical Research at St. James's
University of Leeds
Leeds Gastroenterology Institute
Leeds Teaching Hospitals Trust
Leeds
UK
简介
ACF served on the National Institute for Health and Care Excellence (NICE) guideline committee for clinical guideline CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management.
利益声明
ACF declares that he has no competing interests. ACF is an author of a Cochrane systematic review cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. Oct 2019 [internet publication].全文
UK Health Security Agency. Helicobacter pylori in dyspepsia: test and treat. Jan 2025 [internet publication].全文
Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.全文 摘要
National Institute for Health and Care Excellence. Acute upper gastrointestinal bleeding in over 16s: management. August 2016 [internet publication].全文
Siau K, Hearnshaw S, Stanley AJ, et al. British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding. Frontline Gastroenterol. 2020;11(4):311-23.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Câncer esofágico
- Câncer de estômago
- Doença do refluxo gastroesofágico (DRGE)
更多 鉴别诊断指南
- Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management
- Acute upper gastrointestinal bleeding in over 16s: management
更多 指南医学计算器
Escore de Glasgow Blatchford para hemorragia digestiva
Escore de Rockall para hemorragia digestiva alta
更多 医学计算器患者教育信息
Úlceras pépticas
更多 患者教育信息
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