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Management of Non-ulcer Dyspepsia (functional dyspepsia) in Primary Care
If H.pylor test is
positive then (A) else (B)
Step (A) If H.pylori test
- Use H pylori eradication therapy as described in linked item. Do not re-test
unless there is a strong clinical need.
no response then (B)
- if response then return to self-care
(B) if H.pylori test is negative
- low-dose PPI or H2RA for one month,
- low-dose PPI or H2RA as required (offer low-dose treatment, possibly on
an as-required basis) then (C)
Step (C) Review - In some patients with an inadequate response to therapy
or new emergent symptoms it may become appropriate to refer to a specialist
for a second opinion. Emphasise the benign nature of dyspepsia. Review longterm
patient care at least annually to discuss medication and symptoms.
- avoid long-term, frequent dose, continuous antacid therapy (it only relieves
symptoms in the short term rather than preventing them)
For full details then refer to the full guideline (1).
- NICE (September 2014).Dyspepsia
and gastro-oesophageal reflux disease - Investigation and management of dyspepsia,
symptoms suggestive of gastro-oesophageal reflux disease, or both
Last reviewed 01/2018