A physical examination by a health care professional may reveal mid-abdominal pain. A rectal examination may be done to rule out bleeding. If blood is found on rectal exam, laboratory studies, including a blood count may be ordered. Endoscopy and barium studies may be used to rule out underlying gastrointestinal disease. Upper gastrointestinal x-ray studies using barium may allow for visualization of abnormalities. Endoscopy permits collection of tissue and culture specimens which may be used to further confirm a diagnosis.
The treatment of dyspepsia is based on assessment of symptoms and suspected causative factors. Clinical evaluation is aimed at distinguishing those patients who require immediate diagnostic work-ups from those who can safely benefit from more conservative initial treatment. Some of the latter may require only reassurance, dietary modifications, or antacid use. Medications to block production of stomach acids, prokinate agents, or antibiotic treatment may be considered. Further diagnostic investigation is indicated if there is severe abdominal pain, pain radiating to the back, unexplained weight loss, difficulty swallowing, a palpable mass, or anemia. Additional work-up is also indicated if a patient does not respond to prescribed medications.
Statistics show an average of 20% of patients with dyspepsia have duodenalor gastric ulcer disease, 20% have irritable bowel syndrome, fewer than 1% of patients had cancer, and the range for functional, or nonulcer dyspepsia (gastritis or superficial erosions), was from 5–40%.
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Goldfinger, S. E. "Sensitive Stomachs: Non-ulcer Dyspepsia." Harvard Health Letter (Jan. 1992): 4-5.
Talley, N. J. "Non-ulcer Dyspepsia: Current Approaches to Diagnosis and Management." American Family Physician (May 1993): 1407-1416.
Kathleen D. Wright RN, The Gale Group Inc., Gale, Detroit,