Dyspepsia describes a constellation of symptoms centred in the upper
abdomen. In functional dyspepsia, no discernible organic pathology is found. Diagnosis
and management of these patients are challenging but centred on individual symptom
management. In organic dyspepsia, patients are found to have a number of disorders to
account for their symptoms. These include gastritis and peptic ulceration. Gastritis
refers to a group of diseases characterized by inflammation of the gastric mucosa. It
can be acute or chronic in nature and may involve part or all the stomach. H. pylori
infection gives rise to Type B atrophic gastritis where the inflammatory changes are
accompanied by atrophy and intestinal metaplasia. There is an increased risk of
intestinal type gastric cancer. Other types of gastritis are less common. Peptic ulcer
disease and its complications remain a significant cause of morbidity and mortality. It
is most commonly caused by H. pylori infection or the use of non-steroidal antiinflammatory
drugs. Management involves the use of PPIs together with eradication
therapy of H. pylori. The management of perforation and gastric outlet obstruction is
mainly surgical. The management of upper gastro-intestinal bleeding consists of
resuscitation and haemostasis mainly by endoscopic therapy. In-hospital mortality from
bleeding peptic ulcers remains high. Acute gastric dilatation and gastric volvulus are
surgical emergencies. The management must commence early by resuscitation
followed by prompt surgical management. Mortality remains high in vulnerable and
compromised patients.
Keywords: Dyspepsia, Endoscopic therapy, Functional dyspepsia, Gastric
dilatation, Gastric outlet obstruction, Gastric volvulus, Gastritis, Gastropexy,
Gastro-enterostomy, H. pylori, Peptic Ulcers, Pyloroplasty, Upper GI bleeding.