You're browsing as an anonymous user. Join the community today to view notes at your university, edit pages, and share knowledge!


From Mediwikis



Dyspepsia, from the Greek duspeptos meaning "difficult to digest", is a broad term defined as one or more of:

  1. post-prandial fullness (after a meal)
  2. early satiety (unable to finish a meal)
  3. epigastric pain or burning
  4. heartburn (retrosternal pain or burning)

Dyspepsia vs. Indigestion

Dyspepsia must not be confused with indigestion, which is a vague term used by patients to describe dyspepsia, bloating, nausea or vomiting. Find out exactly what your patient means!

The Stomach

The stomach is a battlefield between the forces of attack and defence. Managing dyspepsia is about maintaining the balance of power, a careful equilibrium between the two sides:

Attack Defence
- gastric acid

- pepsin

- Helicobacter pylori

- bile salts

- mucin

- cellular mucous

- bicarbonate

- mucosal blood flow

- cello turnover

Signs & Symptoms[1][3][4]

  • post-prandial fullness
  • early satiety
  • epigastric pain, tenderness or burning, often related to hunger, specific food or time of day
  • heartburn
  • reflux
  • bloating
  • ALARM Symptoms:
    • Anaemia (iron deficiency)
    • Loss of weight
    • Anorexia
    • Recent onset/progressive symptoms
    • Melaena/haematemesis
    • Swallowing difficulty

Investigations & Management[1][3][4]

OGD: oesophagogastroduodenoscopy (upper GI endoscopy)

Drugs which cause dyspepsia: NSAIDs e.g. ibuprofen

Lifestyle changes: stop smoking, decrease alcohol intake, avoid aggravating foods, avoid stress

Antacids: available over-the-counter e.g. magnesium trisilicate

Test for H. pylori: urea breath test, stool antigen, serology etc

PPI: proton pump inhibitor e.g. omeprazole, lansoprazole

H2 blocker: Histamine H2-receptor antagonist e.g. ranitidine

Triple therapy: omeprazole 20 mg + amoxicillin 1g + clarithromycin 500 mg OR lanzoprazole 30 mg + metroidazole 400 mg + clarithromycin 250 mg BD for one week


What might you find on OGD?


  1. 1.0 1.1 1.2 1.3 Longmore M et al. Oxford Handbook of Clinical Medicine. 9th ed. Oxford: Oxford University Press, 2014.
  2. Martin EA (ed.). Concise Medical Dictionary. 8th ed. Oxford: Oxford University Press, 2010.
  3. 3.0 3.1 3.2 3.3 Ah-See KW et al. BNF 65. London: BMJ Group, 2013.
  4. 4.0 4.1 Sadowski DC et al. Five Things to Know About... Dyspepsia. CMAJ 2015;187(4):doi:10.1503/cmaj.141606.
  5. Holtmann G, Talley NJ. Functional dyspepsia. Curr Opin Gastroenterol 2015;31(6):492-8.