Dyspepsia, heartburn and indigestion, in adults

K30/R12


DESCRIPTION

Dyspepsia, heartburn and indigestion are common conditions and may be caused by gastro-oesophageal reflux.
These conditions often present with epigastric discomfort and minimal change in bowel habits.
Intermittent indigestion, heartburn or dyspepsia may be associated with:

  • use of NSAIDs e.g. aspirin, ibuprofen, pain powders
  • spicy food, alcohol, carbonated drinks
  • smoking

Note: Dyspeptic symptoms may possibly be due to acute coronary syndrome.

GENERAL MEASURES

  • Stop smoking.
  • Limit alcohol intake.
  • Eat small frequent meals.
  • Avoid late night meals.
  • Check haemoglobin.
  • Stop the use of potential ulcerogenic medicines e.g. NSAIDs.

MEDICINE TREATMENT

Initiate medicine therapy with:

  • Proton-pump inhibitor e.g.:
  • Lansoprazole, oral, 30 mg, daily for a maximum of 14 days.
    • Also indicated for short-term use in pregnancy.
    • Refer if symptoms recur after 14-day course of therapy.

REFERRAL

  • Presence of warning signs:
    • weight loss
    • anaemia
    • persistent vomiting
    • haematemesis
    • dysphagia
    • palpable abdominal mass
  • No response within 7 days of starting proton-pump inhibitor therapy treatment.
  • Recurrence of symptoms, especially:
    • > 50 years of age
    • previous gastric surgery
    • family history of gastric carcinoma