Management of uninvestigated dyspepsia: review and commentary

Up to 40% of individuals complain of dyspepsia but only 25% of these present to their general practitioner. If symptoms have been present for a relatively short period the majority can be managed by reassurance and symptomatic treatment. Those with a longer history require empirical treatment with more powerful medication, endoscopy, testing for Helicobacter pylori, or a combination of these approaches. There is some debate about whether the treatment of Helicobacter pylori infection is an appropriate strategy for patients with dyspepsia. It is the general practitioner who determines how the uninvestigated patient with dyspepsia will be managed because those referred to hospital usually undergo endoscopy at an early stage.