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Upper Gastrointestinal Conditions: Nonmalignant Conditions of the Stomach.

FP Essentials 2017 July
Functional dyspepsia can be categorized into two syndromes: postprandial distress syndrome and epigastric pain syndrome. Helicobacter pylori infection is one of the most common chronic infections worldwide. Acute H pylori infection causes dyspepsia, and chronic infection can cause peptic ulcer disease. H pylori also is one of the causative agents in gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. The incidence of H pylori infection varies among different ethnic populations and geographic locations. Screening for and eradication of H pylori infection in healthy asymptomatic high-risk individuals has reduced the incidence of gastric cancer significantly. H pylori eradication is the first-line treatment in patients with low-grade mucosa-associated lymphoid tissue lymphoma and may be curative. The monoclonal fecal antigen test and urea breath test identify active infection, confirm eradication, and have high negative and positive predictive values regardless of H pylori prevalence. Decreasing outpatient usage of antibiotics decreases H pylori resistance. The American Society for Gastrointestinal Endoscopy recommends screening for premalignant lesions in the stomach only in patients with a family history or from a high-risk ethnic group. Gastroparesis is a debilitating condition that requires care from a multidisciplinary team that can offer different management modalities.

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