management
Last reviewed 01/2018
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:
- BSG (2002). Dyspepsia management guidelines.
- Moayyedi P et al. Pharmacological interventions for non-ulcer dyspepsia. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD001960. Review.
NICE guidance - management of dyspepsia in adults in primary care (summary section)
NICE guidance - management of non-ulcer dyspepsia in primary care