Kugler T. Clinical and pathogenetic features of Functional dyspepsia, optimization of its therapy

The thesis is devoted to the diagnosis and treatment of functional dyspepsia (FD). It was found an association between the gastric acid, gut dysmotility, APUD-peptides, H.pylori infection and clinical features of patients with FD. The plasma ghrelin levels were significantly lower in FD patients, especially in PDS compared with control (p<0,05). The plasma GLP-1 levels were higher in FD patients (p<0.01). Ghrelin levels correlate with GLP-1 levels (R=0,492, p<0,001). Anxious and depressive disorders were consistently associated with severity of FD (p<0.05). We assessed a negative correlation (R = -0311, P = 0,004) between the quality of life by SF-8 (PCS) and depression in patients with FD. A new strategy of treatment FD by enzyme supplementation was developed and implemented in practice. After 4 weeks, good clinical effect was achieved in 82,4% of patients with gastroduodenal dysmotility (OR = 3,01 (95 % CI 1,21-7,51), p = 0,0180). NNT = 4,6 (95 % CI 2,7-24,8), p = 0,028. Eradication therapy was successful in 91,3 %, but elimination of dyspeptic symptoms was observed in 40,5% of patients with FD. H.pylori-associated dyspepsia was diagnosed in 23.8% of patients with successful eradication.