epidemiology, associated factors, and treatment experiences with dyspepsia in iran: a review

dyspepsia is a common gastrointestinal symptom reported in 2.9-29% of the adult iranian population. this symptom usually results from functional disease, but in one-third of cases an organic cause such as peptic ulcers, esophagitis, and in less than one percent gastric cancer can be found. the timing of an endoscopic evaluation, the value of acid reducing agents, herbal medicine and the role of helicobacter pylori (hp) eradication are important challenges in the evaluation and management of dyspepsia. overall, prompt endoscopic evaluation for cases over the age of 45 years, those who present with alarm symptoms, or non-responders to empirical acid reducing treatment is recommended. there are controversial results about the role of hp eradication on the relief of dyspepsia symptoms in our region, so the hp test and treatment strategy or eradication therapy for those with functional dyspepsia is not a suitable option for our country. there are promising reports regarding the effects of herbal medicine, and anti-depresants, which needs more research. due to the limited value of alarm features for diagnosis of gastric cancer, we recommend prompt, low cost endoscopic evaluations in all dyspeptic cases over age 45 years.