Non-Ulcerative Dyspepsia

last authored:
last reviewed:

Introduction

Functional dyspepsia is the persistent or recurrent pain or discomfort, centred in upper abdomen.

not releived be defecation or associated with change in stool frequenct or stool form.

no evidency of organic probs

if heartburn and/or regurgitation, manage as GERD.

if on NSAIDs, try to reduce use or add PPI.

Ensure cardiac problems are not the cause of the chest pain.

Upper endoscopy and/or abdominal ultrasound are useful. Look for gall bladder disease.

If 45, or with alarm features (bleeding/anemia, weight loss, dysphagia, or protracted vomiting) do upper GI endoscopy.

If below 45, test and treat for H pylori.

If endoscopy is normal, consider rapid urease test.

If no, re-evaluate symptoms and diagnosis. Consider other sources of pain: pancreas, colon, biliary tract. Delayed gastric emptying?

IBS?

panic disorders or other psychological issues? consider antidepressants, hypnotherapy, behaviour therapy, or pro-kinetic agents

authors:

reviewers: