Evaluation and management of dyspepsia

Oralia V. Bazaldua, F. David Schneider

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Dyspepsia, often defined as chronic or recurrent discomfort centered in the upper abdomen, can be caused by a variety of conditions. Common etiologies include peptic ulcers and gastroesophageal reflux. Serious causes, such as gastric and pancreatic cancers, are rare but must also be considered. Symptoms of possible causes often overlap, which can make initial diagnosis difficult. In many patients, a definite cause is never established. The initial evaluation of patients with dyspepsia includes a thorough history and physical examination, with special attention given to elements that suggest the presence of serious disease. Endoscopy should be performed promptly in patients who have 'alarm symptoms' such as melena or anorexia. Optimal management remains controversial in young patients who do not have alarm symptoms. Although management should be individualized, a cost-effective initial approach is to test for Helicobacter pylori and treat the infection if the test is positive. If the H. pylori test is negative, empiric therapy with a gastric acid suppressant or prokinetic agent is recommended. If symptoms persist or recur after six to eight weeks of empiric therapy, endoscopy should be performed.

Original languageEnglish (US)
Pages (from-to)1773-1784
Number of pages12
JournalAmerican Family Physician
Volume60
Issue number6
StatePublished - Oct 15 1999

ASJC Scopus subject areas

  • Family Practice

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