Case presentation

Asist. Univ. Dr. Bogdan Miutescu

Clinica de Gastroenterologie si Hepatologie
 Admission
IP 61 years old from the urban area is brought to
UPU SCJUT with :
• Burning / Abdominal pain in the epigastric area
• Nausea, postprandial fullness
• Belching

Pathological history - Type 2 diabetes mellitus,

Grade 1 obesity, Grade II essential
hypertension
 Clinical exam

• Intermittent abdominal pain with a moderate / high

intensity burn.
• Postprandial meteorism in the upper abdominal floor
• Cardiovascular system: HR- 84 pbm, BP- 155/86
mmHg.
 Blood Tests

• CBC : H =5.01 mil/mmc, Hb = 13.3 g/dl, Ht =

40.1 %, L = 9251/mmc
• Helicobacter pylori antibodies - negative
 Paraclinic examination

• EKG- HR-84 bpm, QRS intermediate axis.

• Abdominal ultrasound: biliary lithiasis.
• Upper digestive endoscopy: hiatal hernia,
esophagus with reflux esophagitis lesions.
 Secondary diagnostics

• Type 2 diabetes mellitus

• Grade 1 obesity
• Grade II essential hypertension
 Differential diagnosis of functional
dyspepsia

- Gastric cancer
- Chronic gastritis
- Secondary Gastroparesis (Diabetes,
Collagenosis, Myopathy, Paraneoplasty)
- Irritable bowel syndrome
- Chronic pancreatitis
- Ischemic colitis
 Complications
• Without organic complications, but with
decreasing the quality of life.
 Treatment
Hygiene-dietary treatment:
• Change of lifestyle and awareness of the
benign, but recurrent character of the disease
• 5 meals / day (3 main meals and 2 snacks).
• Foods that produce symptoms (acidic, spicy,
fat-containing foods) should be excluded for a
limited period of time.
• It is recommended to avoid NSAIDs, abuse of
coffee, alcohol, smoking.
 Treatment
Pharmaceutical treatment:
• PPI and anti H2
• Prokinetics
• Anti-histamine H1 medication useful in the
subclasses of patients with FD and duodenal
eosinophilia. (Further studies are required).
Thank you!