Dyspepsia

Key points

• Urgent (2-week) endoscopy referral: ALL dysphagia · upper abdominal mass consistent with stomach cancer · age ≥55 with weight loss + (upper abdominal pain/reflux/dyspepsia).
• Non-urgent referral: haematemesis · age ≥55 with treatment-resistant dyspepsia, or upper abdominal pain + low Hb, or raised platelets + nausea/vomiting/weight loss/reflux/dyspepsia.
• Undiagnosed dyspepsia: 1) review medications 2) lifestyle advice 3) full-dose PPI 1 month OR H. pylori test-and-treat.
• H. pylori testing: carbon-13 urea breath test or stool antigen test; no antibiotics within 4 weeks and no PPI within 2 weeks of breath test.

Decision points in this pathway

• Dysphagia · upper abdominal mass · age ≥55 + weight loss + pain/reflux/dyspepsia?
• Haematemesis · age ≥55 with resistant dyspepsia/pain+low Hb/raised platelets+symptoms?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.