Update on Indigestion

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Practice Guidelines

Background:

• Dyspepsia is a common condition impacting quality of life and work productivity.
• Management strategies vary, particularly based on patient age.
• Functional dyspepsia is diagnosed when no organic cause is identified.

Purpose of the Study:

• To outline guideline-based management for dyspepsia.
• To differentiate diagnostic and treatment approaches based on patient age.
• To provide recommendations for refractory cases and complementary therapies.

Main Methods:

• Review of current clinical guidelines for dyspepsia management.
• Age stratification for diagnostic recommendations (endoscopy vs. H. pylori testing).
• Outline of stepwise therapeutic interventions.

Main Results:

• Patients <60 years: Recommend Helicobacter pylori (H. pylori) test-and-treat over routine endoscopy.
• Patients ≥60 years: Recommend routine endoscopy.
• First-line treatment: H. pylori eradication and proton pump inhibitor (PPI) use.

Conclusions:

• Age-appropriate diagnostic strategies are crucial for dyspepsia management.
• A stepwise treatment approach, including H. pylori eradication and acid suppression, is recommended.
• Tricyclic antidepressants, prokinetics, and psychological therapy are options for refractory symptoms; complementary therapies lack evidence.