Dyspepsia
** Consider heartburn as ischaemic heart disease until proved otherwise **
Murtagh's diagnostic model
Probability diagnosis
- Irritable upper GIT (functional dyspepsia)
- Gastro-oesophageal reflux
- Oeosphageal motility disorder (dysmotility)
Serious disorders not to be missed
- Neoplasia: stomach, pancreas, oesophagus
- Cardiovascular: ischaemic heart disease and congestive cardiac failure
- Pancreatitis
- Peptic ulcer
Pitfalls
- Myocardial ischaemia
- Food allergy (e.g. lactose intolerance)
- Pregnancy (early)
- Biliary motility disorder
- Other gall bladder disease
- Post vagotomy
- Duodenitis
- Rarities
- Hyperparathyroidism
- Mesenteric ischaemia
- Zollinger - Ellison syndrome
- Kidney failure
- Scleroderma
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