英國國民保健體系（ＮＨＳ）在２００４年８月２６日公布了一項在一級醫(yī)療體系中如何診治消化不良的新指南。該指南提供了針對成人消化不良癥狀和基礎(chǔ)病因的 循證建議，規(guī)定了一級醫(yī)療體系中的醫(yī)務(wù)人員如何針對消化不良成年患者開展各項診療活動。該指南涉及了一級醫(yī)療體系中的醫(yī)務(wù)人員，包括全科醫(yī)師、護士、社區(qū) 藥師和其他與病人直接接觸的初級保健專業(yè)人員。但二級醫(yī)療體系的醫(yī)務(wù)人員也要對該指南有所了解，確保病人得到連續(xù)治療。該指南將在英格蘭和威爾士的國民保 健體系中推廣使用。

《2010NHS消化不良管理指南》內(nèi)容預(yù)覽

Dyspepsia is a common complaint. More is spent on drugs for dyspepsia than on any other treatment for a symptom group. Universal investigation for dyspepsia is neither clinically desirable nor affordable and rational management poses a challenge.
Dyspepsia is a group of symptoms and is not itself a disease. According to the Rome II definition, dyspepsia refers to pain or discomfort centred in the upper abdomen. Pain in the lower abdomen does not constitute dyspepsia. “Discomfort” refers to subjective negative sensation such as upper abdominal fullness, early satiety, bloating, belching, nausea, retching and/or vomiting.
Up to 40% of the adult population suffer from dyspepsia/heartburn in any one year. The main causes are GORD (15-25%), gastric and duodenal ulcers (15-25%), and stomach cancer (2%). The remaining 60% are classified as “non-ulcer dyspepsia” (NUD) or “functional dyspepsia” (the preferred term these days). Such patients have symptoms but on investigation no causal pathology or disease is identified. Medication is not necessary for all patients with functional dyspepsia. There is a substantial placebo response to therapy. When medication is given, short-term treatment, intermittent if necessary, is likely to be more appropriate than long-term continuous therapy. Functional dyspepsia is not a condition caused by gastric hypersecretion: acid secretion is usually normal.

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