Dyspepsia Tool Kit

HKC Bottom Line

• The majority of dyspepsia is functional or non-ulcer dyspepsia (NUD). Most people with NUD don't require continuous long-term therapy. People with ulcers require short-term triple therapy. Key tasks are ruling out alarm features, use of NSAID's, and considering H.pylori status.

HKC Recommended Article

• Scottish Intercollegiate Guidelines Network. Dyspepsia (Mar 2003).
   » Short
   » Long

Disease Overview

• BMJ 10-Minute Consultation. Dyspepsia (Mar 2001).
  Brief and provides key questions/tips to consider when diagnosing dyspepsia.
  
  
• American Family Physician. Evaluation and Management of Dyspepsia (Oct 1999).

  Differential Diagnosis

• BMJ Clinical Review. ABC of the Upper Gastrointestinal Tract. Indigestion: When is it Functional? (Dec 2001) Brief and provides a good overview of the symptomatology of dyspeptic conditions, highlighting specifically functional dyspepsia.
  
  
• BMJ Clinical Review. ABC of the Upper Gastrointestinal Tract. Oesophagus: Atypical chest pain and motility disorders (Oct 2001). Okay, but focuses primarily on the descriptors and causes of esophageal pain.
  
  
• BMJ Clinical Review. ABC of the Upper Gastrointestinal Tract. Anorexia, nausea, vomiting, and pain (Dec 2001). Provides a differential for the various causes of these symptoms, although PUD & functional dyspepsia are still #1. Information not as organized as the above BMJ article, "Indigestion, When is it Functional?"

Management and Prescribing Advice

  General

• 2003 Scottish Intercollegiate Guidelines Network. Dyspepsia Quick Reference Guide (2003). Key considerations for dealing with dyspepsia plus a decent algorithm.
  
  
• BMJ Clinical review. Management of Gastro-Oesophageal Reflux Disease in General Practice (Feb 2001). Comprehensive overview and general principles on management.
  
  
• BMJ Clinical Review. ABC of the upper gastrointestinal tract. Oesophagus: Heartburn (Sept 2001). Another review of GERD assessment but provides a little bit more breadth on specific management strategies than the above BMJ clinical review.

  Drug Specific

• Rx Files. Oral Acid Suppression Comparison Chart (Jul 2003).
  
  
• Rx Files. H. Pylori Eradication Regimes Comparison Chart (Jul 2003). Overview of the most commonly prescribed regimens
  
  
• Rx Files. H. Pylori Eradication Regimens (Mar 1999). Provides some background on HP management, specifics of the drugs, and a list of common Q & A. Some information may be outdated, (e.g. Pylorid^® information, stats on resistance patterns).

Algorithms

• American Family Physician. Management Stages for Gastroesophageal Reflux Disease-Algorithm (Mar 1999).
  
  
• American Family Physician. Evaluation and Management of Dyspepsia-Algorithm (Oct 1999).

Guidelines

• Guideline Advisory Committee. GERD: Summary of Recommended Guideline

Patient Resources

• AAFP. Dyspepsia: What it is and What to do About it (Feb 2003).
  
  
• Best Practice of Medicine. GERD (Sept 2003).