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Dyspepsia - unidentified cause - Management
How do I manage dyspepsia in someone with alarm features?
- For people with dyspepsia and significant acute gastrointestinal bleeding arrange immediate admission to hospital.
- For all other people with dyspepsia and alarm features:
- Arrange endoscopy within 14 days and do a full blood count.
- Suspend nonsteroidal anti-inflammatory drugs while awaiting referral. Offer alternative analgesics (e.g. paracetamol and/or opioids).
- The management of other drugs will depend on clinical judgement of the benefits and risks of continued treatment. When there is uncertainty seek specialist advice. Management options include:
- Stopping the drug.
- Reducing the frequency or dose of the drug.
- Substituting the drug for one less likely to cause bleeding or dyspepsia.
- Review and manage lifestyle factors known to exacerbate dyspepsia.
- Prescribe either an alginate or an antacid to relieve dyspepsia whilst awaiting endoscopy. Ensure that proton pump inhibitors or H2-receptor antagonists (including those obtained over-the-counter) are not used, for a minimum of 2 weeks, before endoscopy.
- Advise those people who deteriorate significantly to seek medical attention.
In depth
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