The treatment of dyspepsia

Dyspepsia may result from over-indulgence in alcohol and food, or from anxiety and emotional problems. It may also indicate a peptic ulcer, oesophagitis or less commonly, gallstones or gastric cancer. Investigation by endoscopy or barium studies is always indicated when an organic lesion is suspected. Reassurance, tranquillizers and antispasmodics help patients with functional dyspepsia. Antacids given hourly between meals are important in the treatment of all symptomatic peptic ulcers. Cimetidine causes rapid symptomatic relief of duodenal ulcer symptoms, and most ulcers will heal with six weeks' therapy. Gastric ulcer can be treated with carbenoxolone, but this drug is avoided in the elderly and in patients with cardiac failure or hypertension. Anticholinergic drugs are of value in duodenal ulcer, especially for night pain, but they should not be used in patients over the age of 50. Special diets are of no value. For the heartburn of oesophagitis, weight reduction and a regime of regular antacid therapy remain the important measures.