Resolution of the Expert Council «Unexplored Dyspepsia: Short-term and Long-term Patient Management Strategies»

Purpose. To present the materials of the Expert Council, which was held on April 22, 2023 in Moscow and dedicated to modern approaches to the management of patients with unexplored dyspepsia, as well as the choice of the optimal Helicobacter pylori eradication therapy scheme in the Russian Federation. The main provisions of the resolution. An initial patient with recent dyspeptic symptoms who has not taken drugs that can cause gastric damage should be considered as a patient with undiagnosed dyspepsia. The first diagnosis to be excluded in a patient with unexplored dyspepsia is H. pylori-associated chronic gastritis. In order to alleviate or eliminate the symptoms of dyspepsia in the period before testing for H. pylori, the appointment of the prokinetic itopride hydrochloride is recommended, given the lack of influence on the results of the examination, proven efficacy and high safety profile, as demonstrated in studies on the original drug. The patient's presence of objective signs of gastrointestinal bleeding, unmotivated weight loss, aggravated family history of gastric cancer, as well as age over 50 years are indications for esophagogastroduodenoscopy with biopsy. An initial positive test for H. pylori is an indication for eradication therapy, as infection is a major etiological factor in gastric adenocarcinoma, including proximal gastric cancer and cancer of the gastroesophageal junction. Quadruple therapy with clarithromycin (amoxicillin + clarithromycin + proton pump inhibitor + bismuth tripotassium dicitrate) for 14 days can be defined as first-line therapy in the Russian Federation. In order to increase the effectiveness of eradication, the use of original preparations is recommended