NICE guidance - management of non-ulcer dyspepsia in primary care

Last reviewed 01/2018

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 is positive

  1. Use H pylori eradication therapy as described in linked item. Do not re-test unless there is a strong clinical need.
    1. if no response then (B)
    2. if response then return to self-care

Step (B) if H.pylori test is negative

  • low-dose PPI or H2RA for one month, followed by
  • 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).


  1. NICE (September 2014).Dyspepsia and gastro-oesophageal reflux disease - Investigation and management of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease, or both