Abstract
For patients with dyspepsia without alarm features who are not taking a non-steroidal anti-inflammatory drug (NSAID):
Do a full blood count if there are any features of anaemia Review and manage lifestyle factors known to exacerbate dyspepsia Prescribe, or advise the use of, an antacid or alginate as required for immediate relief of dyspepsia
Prescribe additional drug treatment to settle persistent symptoms:
Depending on personal preference, treat with either a proton pump inhibitor (PPI) at full dose for 1 month or test and treat for H. pylori.
For people who have not responded to a PPI, test and treat for H. pylori. For people who have not responded to treatment for H. pylori, treat with a PPI for 1 month.
For people responding to neither a PPI nor a treatment for H. pylori, prescribe either a prokinetic (domperidone, metoclopramide) or an H2-receptor antagonist for 1 month.
Refer those people not responding to all three treatment steps to secondary care for further management.