Black CJ, Houghton LA, Ford AC (30 de octubre de 2018). «Insights into the evaluation and management of dyspepsia: recent developments and new guidelines». Therap Adv Gastroenterol (Revisión) 11: 1756284818805597. PMC6207968. PMID30397412. doi:10.1177/1756284818805597. «The risk of malignancy predominantly relates to increasing age, and so guidelines have previously recommended upper GI endoscopy to routinely investigate dyspepsia only when patients are aged 55 years and older. The ACG/CAG guideline has now raised this age threshold to 60 years. This recommendation is made on the basis of a cost-effectiveness analysis showing that, at all ages, upper GI endoscopy for investigating dyspepsia was dominated by alternative management strategies and that, using a threshold of 55 years, the evidence that upper GI endoscopy was cost-effective was borderline. Currently, the age threshold used in NICE guidance remains at 55 years old or over, but it is important to acknowledge that cost-effectiveness decisions may vary between countries due to differences between patient populations and healthcare systems. (...) With the exception of recommendations related to H. pylori testing and the prescription of PPIs, which are made on the basis of high-quality evidence, all of the other recommendations made in current guidelines for the management of dyspepsia draw on evidence which is moderate at best, the majority being underpinned by low or very low-quality evidence. Consequently, there are still many elements of the evaluation and management of dyspepsia that require further research. Future studies should focus on refining symptom-based definitions of FD to make them more specific and exploring whether certain clusters or patterns of red-flag symptoms are better able to predict the presence of organic disease, in order to prioritize access to endoscopic investigation».
Carmona-Sánchez, R.; Gómez-Escudero, O.; Zavala-Solares, M.; Bielsa-Fernández, M. (octubre a diciembre de 2017). «Consenso mexicano sobre la dispepsia». Revista de gastroenterología de México82 (4): 309-327. doi:10.1016/j.rgmx.2017.01.001. Consultado el 2 de febrero de 2019.
Du L, Chen B, Kim JJ, Chen X, Dai N (abril de 2018). «Micro-inflammation in functional dyspepsia: A systematic review and meta-analysis». Neurogastroenterol Motil (Revisión Sistemática con Metaanálisis) 30 (4): e13304. PMID29392796. doi:10.1111/nmo.13304. «In conclusion, our meta-analysis demonstrated gastroduodenal mast cell and eosinophil infiltration among individuals with FD. Although the presence of micro-inflammation shown by other inflammatory cells or cytokines was inconclusive, our results enforced the immunologic effects on the mechanism of altered brain-gut axis in FD.»
Walker MM, Talley NJ (enero de 2017). «The Role of Duodenal Inflammation in Functional Dyspepsia». J Clin Gastroenterol (Revisión) 51 (1): 12-18. PMID27811629. doi:10.1097/MCG.0000000000000740. «Current research suggests pathogens and allergy may be triggers of FD, although there is evidence only by association at present. FD does not mean there is no pathology—it is becoming established that there is subtle inflammation in the GI tract that may accompany the onset and persistence of symptoms. This inflammatory phenotype is characterized primarily by an innate rather than acute immune response, particularly an eosinophil infiltrate in the duodenum in FD. As these infiltrates are subtle and routine histopathology practice does not quantify these cells, the status of functional disorders is not yet appreciated as an inflammatory condition. Recent studies have also shown that systemic responses of increased circulating lymphocytes and elevated proinflammatory cytokines are present. Thus the functional GID is becoming an inflammatory GID and this breakthrough in understanding that functional does not mean none, but subtle pathology, may improve therapeutic options, which are currently aimed at symptom relief rather than targeted at underlying pathology.»
Black CJ, Houghton LA, Ford AC (30 de octubre de 2018). «Insights into the evaluation and management of dyspepsia: recent developments and new guidelines». Therap Adv Gastroenterol (Revisión) 11: 1756284818805597. PMC6207968. PMID30397412. doi:10.1177/1756284818805597. «The risk of malignancy predominantly relates to increasing age, and so guidelines have previously recommended upper GI endoscopy to routinely investigate dyspepsia only when patients are aged 55 years and older. The ACG/CAG guideline has now raised this age threshold to 60 years. This recommendation is made on the basis of a cost-effectiveness analysis showing that, at all ages, upper GI endoscopy for investigating dyspepsia was dominated by alternative management strategies and that, using a threshold of 55 years, the evidence that upper GI endoscopy was cost-effective was borderline. Currently, the age threshold used in NICE guidance remains at 55 years old or over, but it is important to acknowledge that cost-effectiveness decisions may vary between countries due to differences between patient populations and healthcare systems. (...) With the exception of recommendations related to H. pylori testing and the prescription of PPIs, which are made on the basis of high-quality evidence, all of the other recommendations made in current guidelines for the management of dyspepsia draw on evidence which is moderate at best, the majority being underpinned by low or very low-quality evidence. Consequently, there are still many elements of the evaluation and management of dyspepsia that require further research. Future studies should focus on refining symptom-based definitions of FD to make them more specific and exploring whether certain clusters or patterns of red-flag symptoms are better able to predict the presence of organic disease, in order to prioritize access to endoscopic investigation».
Du L, Chen B, Kim JJ, Chen X, Dai N (abril de 2018). «Micro-inflammation in functional dyspepsia: A systematic review and meta-analysis». Neurogastroenterol Motil (Revisión Sistemática con Metaanálisis) 30 (4): e13304. PMID29392796. doi:10.1111/nmo.13304. «In conclusion, our meta-analysis demonstrated gastroduodenal mast cell and eosinophil infiltration among individuals with FD. Although the presence of micro-inflammation shown by other inflammatory cells or cytokines was inconclusive, our results enforced the immunologic effects on the mechanism of altered brain-gut axis in FD.»
Walker MM, Talley NJ (enero de 2017). «The Role of Duodenal Inflammation in Functional Dyspepsia». J Clin Gastroenterol (Revisión) 51 (1): 12-18. PMID27811629. doi:10.1097/MCG.0000000000000740. «Current research suggests pathogens and allergy may be triggers of FD, although there is evidence only by association at present. FD does not mean there is no pathology—it is becoming established that there is subtle inflammation in the GI tract that may accompany the onset and persistence of symptoms. This inflammatory phenotype is characterized primarily by an innate rather than acute immune response, particularly an eosinophil infiltrate in the duodenum in FD. As these infiltrates are subtle and routine histopathology practice does not quantify these cells, the status of functional disorders is not yet appreciated as an inflammatory condition. Recent studies have also shown that systemic responses of increased circulating lymphocytes and elevated proinflammatory cytokines are present. Thus the functional GID is becoming an inflammatory GID and this breakthrough in understanding that functional does not mean none, but subtle pathology, may improve therapeutic options, which are currently aimed at symptom relief rather than targeted at underlying pathology.»
Vargas, Mariela; Talledo-Ulfe, Lincolth; Samaniego, Reimer O.; Heredia, Paula; Rodríguez, Christian A. S.; Mogollón, César A.; Enriquez, Walter F.; Mejia, Christian R. (julio de 2016). «Dispepsia funcional en estudiantes de ocho facultades de medicina peruanas. Influencia de los hábitos». Acta Gastroenterol Latinoam (Sociedad Argentina de Gastroenterología (SAGE)) 46 (2): 95-101. Consultado el 28 de marzo de 2019.
