జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Role of Gastric Acid in Dyspepsia

Samal SC, Pratap Behera, George M Chandy

Functional dyspepsia is a clinical syndrome in which there is an absence of underlying organic disease to explain the symptoms. Empiric acid suppression is one among the many options available in the therapeutic armamentarium to treat this common condition. However the response to acid suppression is not always a consistent one. It is because of the heterogeneous nature of the pathophysiologic mechanisms involving gastric acid in this scenario. This variation in the role of the gastric acids is determined possibly by the genetic constitution and it is influenced by the factors like H. pylori infection, irritants, allergens and diet. All these events primarily lead to visceral hypersensitivity. Finally, it is the degree of affection, whether gastric or duodenal, decides its clinical presentation. If it is a predominant gastric visceral hypersensitivity, presentation would be of Rome III-EPS type, whereas duodenal sensitisation would present as Rome III-PDS.