ROLE OF ENDOSCOPY IN DIAGNOSIS AND TREATMENT OF FUNCTIONAL DYSPEPSIA

Abstract

The Japanese Society of Gastroenterology published up-dated clinical guidelines for functional dyspepsia (FD) in 2021. Management of patients with refractory FD to treatment is challenging. Patients with refractory FD include those with early chronic pancreatitis (ECP) using endosonography. Notably, prompt treatment of chronic pancreatitis can reduce epigastric pain in patients with ECP; therefore, accurate diagnosis of ECP using endosonography is important. Experimental animal models of FD have shown that duodenal inflammation was an important contributor to the pathophysiology of FD. Reportedly, some patients with FD show pancreatic enzyme abnormalities, which progress to ECP; therefore, evaluation using elastography and endosonography may be important for diagnosis of exocrine pancreatic dysfunction. Additionally, we are doing image analysis used image enhanced endoscopy to observe the appearance of the duodenal mucosa in patients with FD.