GI: Dyspepsia

Question 1

Urgent endoscopic investigation is required if dyspepsia is accompanied by ‘alarm features’ such as what? (5)

Answer 1

1. Bleeding
2. Dysphagia
3. Recurrent vomiting
4. Weight loss
5. Patient is over 55 years with unexplained, recent-onset dyspepsia that has not responded to treatment.

Question 2

Patients with dyspepsia should be advised about what dietary lifestyle changes?

Answer 2

Avoidance of alcohol and of aggravating foods such as fat.

Question 3

Patients with dyspepsia should be given what non-dietary lifestyle advice?

Answer 3

1. Reducing weight if overweight
2. Smoking cessation
3. Raising the head of bed

Question 4

Antacids may provide some symptomatic relief from dyspepsia, however if symptoms persist in uninvestigated dyspepsia, treatment involves what?

Answer 4

A PPI for up to 4 weeks.

Question 5

Patients with uninvestigated dyspepsia, who do not respond to initial trial with a PPI should be tested for what?

Answer 5

Helicobater pylori and given eradication if H. pylori is present.

Alternatively, for example in populations where H.pylori infection is more likely (developing world), the ‘test and treat’ strategy for H. pylori can be used before a trial with a proton pump inhibitor.