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Dyspepsia - unidentified cause - Management
How do I assess someone for alarm features?
For the purpose of this CKS topic, alarm features are defined as:
- Dyspepsia with one or more of the following:
- Chronic gastrointestinal bleeding.
- Progressive unintentional weight loss.
- Progressive difficulty swallowing.
- Persistent vomiting.
- Iron deficiency anaemia.
- Epigastric mass.
- Suspicion of cancer after investigation with a barium meal.
- People over 55 years of age with persistent or unexplained dyspepsia.
Basis for recommendation
- These recommendations for when to refer for endoscopy conform with guidance issued by the National Institute for Health and Clinical Excellence (NICE) [NICE, 2005]. They are based upon evidence, summarized by NICE, of the sensitivity of clinical features to detect cancer. Approximately 4% of people with these features will have gastric cancer.
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