Functional (non-ulcer) dyspepsia

Question 1

This term applies to

Answer 1

the 60% of pts presenting with dyspepsia

• in which there is discomfort on eating
• in the absence of demonstrable organic disease

can be considered in two categories:

1. ulcer-like dyspepsia or
2. dysmotility-like dyspepsia

Question 2

Ulcer-like

Answer 2

Treat as for GORD

• but with a preference for a 4-wk trial of H2-antagonists
• and cease if symptoms resolve.

Question 3

Dysmotility-like dyspepsia

Answer 3

Features of dysmotility

• Discomfort with early sense of fullness on eating
• Nausea
• Overweight
• Emotional stress
• Poor diet (e.g. fatty foods)
• Similar lifestyle to GORD

Management :

Treat as for GORD (Stage 1)

• Include antacids.

If not responsive:

Step 1

• H2-receptor antagonists.

Step 2

• Prokinetic agents:
• domperidone 10 mg tds or
• metoclopramide 10 mg tds