{"id":318,"date":"2017-03-26T12:45:08","date_gmt":"2017-03-26T12:45:08","guid":{"rendered":"http:\/\/papergp.com\/index.php\/gi-and-renal\/dyspepsia\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"dyspepsia","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/gi\/dyspepsia\/","title":{"rendered":"Dyspepsia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Differential diagnosis<\/strong><\/h4>\n<ul>\n<li>Stomach\/oesophageal Ca &#8211; weight loss, dysphagia<\/li>\n<li>Ulcer &#8211; melena<\/li>\n<li>MI &#8211; chest pain, SOB, palpitations<\/li>\n<li>GORD\/dyspepsia &#8211; belching, fatty foods, flatulence, heartburn<\/li>\n<li>Medications &#8211; NSAIDs, bisphosphonates, calcium channel blockers, nitrates<\/li>\n<li>Liver\/gallbladder\/pancreas<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;\n<\/p><div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>Red flags &#8211; weight loss, anorexia, recent onset, progressive, vomiting, melena, &nbsp;swallowing difficulties, chest pain\/shortness of breath<\/li>\n<li>Examine &#8211; Abdominal examination<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;\n<\/p><div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, ferritin, LFTs, coeliac<\/li>\n<li>H.pylori stool test (after stopping PPI for 2 weeks)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Explanation\n<ul>\n<li>problem with digestion in upper gut, abdominal pain and bloating are common symptoms, certain triggers should be avoided (NSAIDs, alcohol)<\/li>\n<\/ul>\n<\/li>\n<li>Treatment\n<ul>\n<li>Lifestyle &#8211; stop smoking, reduce alcohol and caffeine, weight loss, foods, stop meds causing it<\/li>\n<li>Gaviscon &#8211; neutralises stomach acid<\/li>\n<li>PPI<\/li>\n<li>H.pylori eradication\n<ul>\n<li>1st line: Omeprazole 40mg BD + Amoxicillin 1g BD + Clarithromycin 500mg BD for 7 days<\/li>\n<li>2nd line: Omeprazole 40mg BD + tripotassium dicitratobismuthate 120mg QDS + tetracycline 500mg QDS + metronidazole 400mg TDS for 14 days<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Follow up \/ Safety-net\n<ul>\n<li>review in 6 weeks<\/li>\n<li>sooner if deterioration e.g. melaena, dysphagia<\/li>\n<li>2ww if:\n<ul>\n<li>&gt;55yo and unexplained and persistent recent onset dyspepsia (avoid PPIs 2 weeks beforehand)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n\n\n<h4 class=\"wp-block-heading\">Reference<\/h4>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/gps.camdenccg.nhs.uk\/pathways\/dyspepsia\">https:\/\/gps.camdenccg.nhs.uk\/pathways\/dyspepsia<\/a> <\/li><li><a href=\"http:\/\/gp.barnetccg.nhs.uk\/downloads\/services\/pathways\/Gastroenterology\/Dyspepsia-protocol-July-2018-v7-3.pdf\">http:\/\/gp.barnetccg.nhs.uk\/downloads\/services\/pathways\/Gastroenterology\/Dyspepsia-protocol-July-2018-v7-3.pdf<\/a> <\/li><\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Stomach\/oesophageal Ca &#8211; weight loss, dysphagia Ulcer &#8211; melena MI &#8211; chest pain, SOB, palpitations GORD\/dyspepsia &#8211; belching, fatty foods, flatulence, heartburn Medications &#8211; NSAIDs, bisphosphonates, calcium channel blockers, nitrates Liver\/gallbladder\/pancreas &nbsp; Data gathering Red flags &#8211; weight loss, anorexia, recent onset, progressive, vomiting, melena, &nbsp;swallowing difficulties, chest pain\/shortness of breath Examine &#8211; &hellip; <a href=\"https:\/\/papergp.com\/index.php\/gi\/dyspepsia\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Dyspepsia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":315,"menu_order":64,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-318","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=318"}],"version-history":[{"count":7,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/318\/revisions"}],"predecessor-version":[{"id":2402,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/318\/revisions\/2402"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/315"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}