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