Dyspepsia

Dyspepsia

• Symptoms referable to the upper gastrointestinal tract

Epidemiology

• 75-90% of population get symptoms
• 4% of all GP consultations

Aetiology

• Non-ulcer (functional) dyspepsia
• GORD
• Gastritis (NSAIDs, H.pylori, bile)
• Peptic ulcer disease
• Gastric malignancy

Clinical features

• Heartburn
• Epigastric pain
• Pain, discomfort or 'fullness' after eating
• Nausea
• Bloating

Alarm signals

• Weight loss
• Vomiting
• Haematemesis, melaena or anaemia
• Dysphagia
• Previous gastric ulcer or gastric surgery
• Non-steroidal anti-inflammatory drugs (NSAIDs)

Investigations

• 13C urea breath test for H.pylori
• H.pylori serology
• Upper GI endoscopy if over 45 years old

Management

• Depends on cause
• Consider a trial of proton pump inhibitors if no alarm signals and age <50