DIAGNOSTIC EVALUATION OF PATIENT WITH DYSPEPSIA SYNDROME AND HEARTBURN BY GP AND PRIMARY CARE PHYSICIAN: NEED OF A NEW & SIMPLE QUESTIONNAIRE

Available data are suggestive that modified version of frequency scale for the symptoms of gastrointestinal reflux disease (mFSSG) consists specific questions reflecting symptoms of reflux and dyspepsia which can be measured in form of Reflux Score (RS) and Dyspepsia Score (DS). By calculating this individual score, it has high positive effect on the pre-investigational identification of Gastrointestinal Reflux Disease and Dyspepsia syndrome respectively. Beyond the significant sensitivity and specificity, mFSSG tool is very convenient for practical use. When DS score is ranged between 6 and 8, the greatest correlation is observed with the fact that clinical criteria for functional dyspepsia are met by patient: lower DS scores are not indicative for starting empirical treatment of dyspepsia. DS score of 8 and above should be regarded as sufficient for the initiation of empirical treatment of uninvestigated dyspepsia. This review recommends using mFSSG questionnaire in the complex diagnostic examinations of patients who have symptoms of gastroesophageal reflux and/or dyspepsia. Those patients with uninvestigated dyspepsia who have mFSSG dyspepsia score of 8 and above can be recommended empiric treatment with fixed dose combination of omeprazole 20mg and domperidone suspended release 30mg. Russian version of the questionnaire yet to be validated in Russian patients population. This review provides practical recommendations on using mFSSG questionnaires by GPs and primary care physicians for making preliminary diagnostic decisions, identify laboratory examinations to be required, and to decide empiric treatment administration for patients with upper gastrointestinal symptoms. mFSSG questionnaire is meant to assist with, not dictate, decision making in conjunction with patients.

изжога, синдром диспепсии, опросники, амбулаторно-поликлиническая помощь

1. Suzuki H, Nishizawa T, Hibi T. Can Helicobacter pylori-associated dyspepsia be categorized as functional dyspepsia? J Gastroenterol Hepatol. 2011;26(suppl 3):42-45

2. Stanghellini V., Armstrong D., Monnikes H., Bardhan K. D. Systematic review: do we need a new gastroesophageal reflux disease questionnaire? // Aliment. Pharmacol. Ther. - 2004. - Vol. 19. P. 463-479.

3. Fass R. Symptom assessment tools for gastroesophageal reflux disease (GERD) treatment. J Clin Gastroenterol. 2007 May-Jun; 41 (5):437-44.

4. Ghoshal UC, Singh R. Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population. J Gastroenterol Hepatol. 2017; 32: 378-387

5. Svedlund J., Sjodin.I, Dotevall G. GSRS - A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease // Dig Dis Sci. - 1988. - Vol. 33. - P. 129-134.

6. Ware JE Jr, Sherbourne CD. The MOS36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30: 473-83.

7. Danjo A, Yamaguchi K, Fujimoto K, Saitoh T, Inamori M, Ando T, et al. Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres. J Gastroenterol Hepatol 2009;24: 633-8.

8. Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998;33:1023-9.

9. Restuti Hidayani Saragih, Imelda Rey. FSSG Scale System in Comparison with GERD Questionnaires in Predicting Endoscopic Findings with Refux Esophagitis. Restuti Hidayani Saragih, Mar 22, 2017:136-140

10. Кайбышева В. О. Результаты многоцентрового наблюдательного исследования по применению международного опросника GerdQ для диагностики гастроэзофагеальной рефлюксной болезни/ В. О. Кайбышева Ю. А. Кучерявый, А. С. Трухманов, О. А. Сторонова, М. Ю. Коньков, И. В. Маев, В. Т. Ивашкин// Российский журнал гастроэнтерологии, гепатологии и колопроктологии 2013 № 5.С1-5.

11. Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda requency scale for the symptoms of GERD. J Gastroenterol. 2004;39:888-91.

12. M, Minashi K, et al. Development and evaluation of FSSG: Tsuboi K, Omura N, Yano F et al. Relationship of the frequency scale for symptoms of gastroesophageal reflux disease with endoscopic findings of cardiac sphincter morphology. J. Gastroenterol. 2008; 43: 798-802.

13. Miyamoto M, Haruma K, Takeuchi K et al. Frequency scale for symptoms of gastroesophageal reflux disease predicts the need for addition of prokinetics to proton pump inhibitor therapy. J. Gastroenterol. Hepatol. 2008; 23: 746-51.

14. Miyamoto M, Manabe N, Haruma K. Efficacy of the addition of prokinetics for proton pump inhibitor (PPI) resistant non-erosive reflux disease (NERD) patients: significance of frequency scale for the symptoms of GERD (FSSG) on decision of treatment strategy. Intern. Med. 2010; 49: 1469-76.

15. Watanabe T, Urita Y, Sugimoto M et al. Gastroesophageal reflux disease symptoms are more common in general practice in Japan. World J. Gastroenterol. 2007; 13: 4219-23.

16. Fujinami H, Kudo T, Miyazaki T et al. The modified glucose clearance test: a novel non-invasive method for differentiating non-erosive reflux disease and erosive oesophagitis. Aliment. Pharmacol. Ther. 2008; 28: 1259-64.

17. Fujiwara Y, Kohata Y, Kaji M et al. Sleep dysfunction in Japanese patients with gastroesophageal reflux disease: prevalence, risk factors, and efficacy of rabeprazole. Digestion 2010; 81: 135-41.

18. Yasaka S, Murakami K, Abe T et al. Evaluation of esophageal function in patients with gastroesophageal reflux disease using transnasal endoscopy. J. Gastroenterol. Hepatol. 2009; 24: 1677-82.

19. Manabe N, Haruma K, Hata J et al. Differences in recognition of heartburn symptoms between Japanese patients with gastroesophageal reflux, physicians, nurses, and healthy lay subjects. Scand. J. Gastroenterol. 2008; 43: 398-402.

20. Enjoji M, Yamada H, Kojima K et al. Scoring system for evaluating functional disorders following laparoscopy-assisted distal gastrectomy. J. Surg. Res. 2010; 164: e229-33.

21. Jinnai M, Niimi A, Takemura M et al. Gastroesophageal reflux-associated chronic cough in an adolescent and the diagnostic implications: a case report. Cough 2008; 15: 4-5.

22. Takenaka R, Matsuno O, Kitajima K et al. The use of frequency scale for the symptoms of GERD in assessment of gastro-oesophageal reflex symptoms in asthma. Allergol. Immunopathol. (Madr) 2010; 38: 20-4.

23. Oridate N, Takeda H, Mesuda Y et al. Evaluation of upper abdominal symptoms using the frequency scale for the symptoms of gastroesophageal reflux disease in patients with laryngopharyngeal reflux symptoms. J. Gastroenterol. 2008; 43: 519-23.

24. Toros AB, Toros SZ, Ozel L et al. Comparative outcomes of antireflux treatment for laryngopharyngeal reflux symptoms and upper abdominal symptoms in patients with endoscopic esophagitis. Eur. Arch. Otorhinolaryngol. 2011; 268: 703-8.]

25. Miyakoshi N, Kasukawa Y, Sasaki H et al. Impact of spinal kyphosis on gastroesophageal reflux disease symptoms in patientswith osteoporosis. Osteoporos. Int. 2009; 20: 1193-8.

26. Togawa R, Ohmure H, Sakaguchi K et al. Gastroesophageal reflux symptoms in adults with skeletal class III malocclusion examined by questionnaires. Am. J. Orthod. Dentofacial Orthop. 2009; 136: 10 e1-6.

27. Yamane Y, Yamaguchi T, Tsumori M et al. Elcatonin is effective for lower back pain and the symptoms of gastroesophageal reflux disease in elderly osteoporotic patients with kyphosis. Geriatr. Gerontol. Int. 2011; 11: 215-20.

28. Muro Y, Sugiura K, Nitta Y et al. Scoring of reflux symptoms associated with scleroderma and the usefulness of rabeprazole. Clin. Exp. Rheumatol. 2009; 27 (3 Suppl. 54): 15-21

29. Drossman DA, Corazziari E, Delvaux M et al., eds. Rome III: The Functional Gastrointestinal Disorders, 3rd edn. McLean, VA: Degnon Associates, 2006.

30. Nagahara A, Asaoka D, Hojo M et al. Observational comparative trial of the efficacy of proton pump inhibitors versus histamine-2 receptor antagonists for uninvestigated dyspepsia. J. Gastroenterol. Hepatol. 2010; 25 (Suppl. 1): S122-8.

31. Kusano M, Hosaka H, Kawada A, Kuribayashi Sh et al. Development and evaluation of modified frequency scale for the symptoms of GERD to distinguish functional dyspepsia from non-erosive reflux disease. Journal of Gastroenterology and Hepatology 27 (2012) 1187-1191

32. Inamori M, Akiyama T, Kato S, et al. Сравнительное изучение удобства вопросников QUEST и FSSG; 11-й Всемирный конгресс Международного общества болезней пищевода; 10-13 сентября; Будапешт. 2008. 167-170

33. Comparative Study of 2 Different Questionnaires in Japanese Patients: The Quality of Life and Utility Evaluation Survey Technology Questionnaire (QUEST) Versus the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease Questionnaire (FSSG) Takashi Nonaka, Takaomi Kessoku, Yuji Ogawa, Shogo Yanagisawa, Tadahiko Shiba, Takashi Sakaguchi, Kazuhiro Atsukawa, Hisao Takahashi, Yusuke Sekino, Hiroshi Iida,1 Hiroki Endo, Yasunari Sakamoto, Tomoko Koide, Hirokazu Takahashi, Masato Yoneda, Shin Maeda, Atsushi Nakajima, Eiji Gotoh, Masahiko Inamori. J Neurogastroenterol Motil. 2013 Jan; 19(1): 54-60

34. Development and evaluation of FSSG: frequency scale for the symptoms of GERD. Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K, Kuribayashi S, Higuchi T, Zai H, Ino K, Horikoshi T, Sugiyama T, Toki M, Ohwada T, Mori M. J Gastroenterol. 2004 Sep;39(9):888-91

35. Categorization of Upper Gastrointestinal Symptoms Is Useful in Predicting Background Factors and Studying Effects and Usages of Digestive Drugs Nobutake Yamamichi, Takeshi Shimamoto, Yoshiki Sakaguchi, Yu Takahashi, Shinya Kodashima, Chiemi Nakayama, Chihiro Minatsuki, Satoshi Ono, Satoshi Mochizuki, Rie Matsuda, Itsuko Asada-Hirayama, Keiko Niimi, Mitsuhiro Fujishiro, […], Kazuhiko Koike [view all] Published: February 5, 2014https://doi.org/10.1371/journal.pone.0088277