Management

Lifestyle Advice

• insufficient evidence to recommend any particular lifestyle advice
  • smokers should be advised not to smoke for general health reasons and healthy eating should be encouraged, though neither are known to affect these symptoms

Pharmacological interventions

• H Pylori eradication - it is recommended H Pylori eradication is used in this condition in keeping with the test and treat strategy.
• antisecretory treatments
  • RCTs have demonstrated small but significant benefits of PPI or H2 receptor antagonist use. Responses are best if dyspepsia is "ulcer-like" or reflux type
  • recommended that antisecretory treatment be considered of potential use in this condition
• stop NSAIDs if possible and consider other drugs as provoking agents
• repeat investigations if serious symptoms develop (e.g. alarm symptoms)

Guidance as to the step-by-step management of non-ulcer dyspepsia has now been provided by NICE (see linked item).

Notes:

• a systematic review revealed that there is evidence that anti-secretory therapy (H2 receptor antagonists, proton pump inhibitors) may be effective in NUD

Reference:

1. BSG (2002). Dyspepsia management guidelines.
2. Moayyedi P et al. Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001960. Review.