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Dyspepsia - unidentified cause - Management
Overview of management
- Arrange emergency admission for anyone with dyspepsia and significant gastrointestinal bleeding.
- Assess people with dyspepsia for alarm features.
- For people with alarm features:
- Refer for endoscopy within 14 days.
- Review and manage drugs known to increase the risk of gastrointestinal bleeding or exacerbate dyspepsia.
- Review and manage lifestyle factors known to exacerbate dyspepsia.
- Prescribe either an alginate or an antacid for symptomatic relief of dyspepsia.
- For people with dyspepsia without alarm features:
- Do a full blood count if there are any features of anaemia.
- Review and manage drugs known to increase the risk of gastrointestinal bleeding or exacerbate dyspepsia.
- Review and manage lifestyle factors known to exacerbate dyspepsia.
- Prescribe, or advise the use of, an antacid or alginate for immediate relief of dyspepsia as required.
- Prescribe additional drug treatment to settle persistent symptoms.
- Refer those people not responding to all three treatment steps to secondary care for further management.
- Prescribe maintenance treatment if dyspepsia recurs following treatment.
- For people with dyspepsia without alarm features, and taking nonsteroidal anti-inflammatory drugs (NSAIDs):
- Do a full blood count if there are any features of anaemia.
- Review and manage lifestyle factors manage lifestyle factors known to exacerbate dyspepsia.
- Prescribe, or advise the use of, an antacid or alginate for immediate relief of dyspepsia as required.
- Stop the NSAID if possible, and prescribe a proton pump inhibitor (PPI) for 1 month, and review.
- When it is not possible to stop the NSAID, prescribe a full-dose PPI for 1 month, then maintain at a dose appropriate to the risk of gastrointestinal bleeding. Test for, and eradicate (if present), H. pylori. Reduce NSAID use if possible.
- Refer those people whose symptoms persist despite treatment.
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