A Reading on

DYSPEPSIA

In Partial Fulfillment of the

Requirements in NCM 215 – RLE

NUTRITION & GASTROINTESTINAL, METABOLISM,

ENDOCRINE ROTATION

Submitted to:

PILAR TERESA J. MEDIDAS, RN, MAN

Clinical Instructor

Submitted by:

SOPHIA ELYSSA D. IBUYAN, St.N

BSN 3K – Group 1

February 16, 2022

Title: The Role of Ultrasonography in the Diagnosis of Functional Dyspepsia

Bibliography: Cvetković, M., Jovanović, I., Crevar-Marinović, S., Branković, M., Mandić,
O., Maksimović, J., Zdravković, N., Simović, S., & Stanisavljević, N. (2021). The
Role of Ultrasonography in the Diagnosis of Functional Dyspepsia. Serbian Journal
of Experimental and Clinical Research, 0(0). https://doi.org/10.2478/sjecr-2021-
0003

Summary:

The most common functional disease of the digestive tube is functional dyspepsia
(FD), which is a syndrome arising from the gastroduodenal section of the digestive tube.
Dyspeptic symptoms affect nearly forty percent of individuals at least once a year, with
the disorder most commonly diagnosed in the fifth decade of life and affecting both sexes
equally. Functional dyspepsia is characterized as the presence of postprandial fullness,
early satiety, epigastric pain, and burning that is severe enough to interfere with daily
activities, according to the ROMA IV criteria. Upper gastrointestinal symptoms including
nausea, belching, or belly bloating can also arise. Patients with functional dyspepsia can
be divided into two groups based on the severity of their symptoms, these are
Postprandial Distress Syndrome (PDS) and Epigastric Pain Syndrome (EPS). In this
published article, a total of sixty participants were studied and recruited from the Medical
Center Bezanijska kosa which located in Serbia. A group of patients who meet the ROMA
IV criteria for FD symptoms includes twenty-one patients with PDS, nine patients with
EPS, and thirty healthy individuals without any symptoms.

During the procedure, a 5 MHz ultrasound probe (Hitachi EUB-5500) was used to
measure the area of the antrum of the stomach. In the sagittal plane scan, the antral area
was visualized between the left lobe of the liver, pancreas, aorta or vein cava inferior and
superior mesenteric vein. The measurements were carried while lying supine in the right
decubitus. The ultrasonography device with built-in caliper and calculating program were
used to measure the antrum's outer profile. The measurements were taken twice and
then averaged to verify the accuracy of the results. Each participant fasted for eight hours
prior to the beginning of the procedure. The antral area was measured at six different time
points: in the fasting state, following the meal intake at 5, 30, 60, 90, and 120 minutes
postprandially. Patients were asked to record the severity of each dyspeptic symptom at
each time point. In this study, slower gastric emptying was found in a patient with
postprandial distress syndrome, compared to subjects with epigastric pain syndrome. The
complaints reported by patients as the most intense ones during the testing were:
belching, postprandial fullness, nausea, bloating, and epigastric pain. None of the patients
re-ported early satiety, heartburn, and vomiting during the testing. Most patients reported
their symptoms in the interval between 6-30 minutes during the testing. From 30 minutes
up to 120 minutes, the average area of the antrum in the control group was smaller. The
level of gastric emptying at 120 minutes after the test meal, was less in patients with
functional dyspepsia than in healthy subjects. Observed at 120 minutes, 16 of 30 patients
had the level of gastric emptying less than 50% in the FD group, while all healthy subjects
had the level of gastric emptying over 50%.

It was further discussed that ultrasonography, as an easy, effective, and non-

invasive modality, could be used in clinical practice to evaluate gastric emptying in both,
healthy participants, and those with gastrointestinal disorders, such as FD. Since the
antrum is the most accessible part of the stomach, they used ultrasonography to measure
gastric emptying by measuring the size of the antrum after the test meal. Although
scintigraphy is the global standard for examining gastric emptying, ultrasound has
advantages because it is non-invasive, reproducible, and does not require expensive
equipment.
Reaction:

Several methods for evaluating the function of the digestive tube are only available
in clinical trials and are not used in everyday practice. The majority of the methods are
invasive and need costly equipment and well-trained personnel. I commend how they
utilize ultrasonography as another option in examining of gastric emptying in the patients.
Although it may have limitations like it is a subjective method and stomach gases has
reduced visibility upon examining, I agree that despite some limitations it can help in
diagnosing functional dyspepsia. As someone who also experienced dyspepsia, I had
nausea, vomiting, epigastric pain, and belly bloating that time. It happened because I was
really hungry and caused me to overeat.

Luckily, with this article I was able to learn that there are other modalities in
diagnosing dyspepsia and as a student nurse I gained new knowledge from it. In order to
prevent this, we as student nurses, should educate not only ourselves but also to the
patients who manifest symptoms of dyspepsia such as eating smaller, more-frequent
meals, chew foods slowly and thoroughly, avoid foods that trigger indigestion like spicy
foods, fried and fast foods.

The implications of this to nursing practice is determined by the nursing care we

should provide in terms of a common digestion problem such as Dyspepsia. We must
have knowledge and skills not only regarding diagnostic examinations but also measures
that would prevent patients from experiencing discomfort by giving them health teachings
in terms of lifestyle, diet, and exercise.

In nursing education, one of the most important undertakings we must remember

is to have knowledge about the underlying cause of the disease as well as what are the
medical and nursing management that must be done so as we are to encounter a patient
with Dyspepsia will be able to use our learnings and apply it to our patients.

With the evidenced-based practice it will help us offer better patient care and with
the use of information and research we can come up with effective conclusions.
Considering the complexity of diagnosing Dyspepsia, all our nursing actions and
responsibilities must come from scientific research for us to provide the care to our
patients.
Copy of the Original Article