Dyspepsia NICE Management

Question 1

When would you refer someone for a suspected cancer endoscopy?

Answer 1

Dysphagia or those aged 55 years and over with weight loss and any of the following: upper abdominal pain, reflux, or dyspepsia.

Question 2

First line dyspepsia with unidentified cause management

Answer 2

Full dose PPI for one month
OR
Test for h. pylori and prescribe eradication treatment if positive

Question 3

Second line dyspepsia management

Answer 3

Try the other first line

Question 4

What tests are recommended for h. pylori?

Answer 4

carbon-13 urea breath test
OR
Stool antigen test

Question 5

What is the therapy for h. pylori infection?

Answer 5

7-day triple therapy of PPI, amoxicillin and either clarithromycin or metronidazole

Question 6

What is the therapy for h. pylori infection if the patient is allergic to penicillin?

Answer 6

7-day triple therapy of PPI, clarithromycin and metronidazole

Question 7

What is the therapy for h. pylori infection if the patient is allergic to penicillin and has had previous exposure to clarithromycin?

Answer 7

7-day quadruple therapy of PPI, metronidazole, a tetracycline and bismuth subsalicylate

Question 8

How long do people have to be off PPI and antibiotics before h.pylori testing?

Answer 8

2 weeks PPI
4 weeks antibiotics

Question 9

If h. pylori re-testing is required, how long after therapy should testing be carried out?

Answer 9

At least 4 weeks and ideally 8 weeks

Question 10

If someone has resistant dyspepsia, what else can you add?

Answer 10

H2 receptor antagonist