Dyspepsia, Heartburn and Indigestion, in Adults

Description

General Measures

Medicine Treatment

Referral

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ICD-10 code: K30/R12

DESCRIPTION

• Dyspepsia, heartburn and indigestion are common conditions and may be caused by gastro-oesophageal reflux or gastroduodenal pathology. These conditions often present with epigastric discomfort and minimal change in bowel habits.
• Intermittent indigestion, heartburn or dyspepsia may be associated with:
  • use of NSAIDs e.g. aspirin, ibuprofen, pain powders.
  • spicy food, alcohol, carbonated drinks.
  • smoking.

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Note:
Dyspeptic symptoms may possibly be due to acute coronary syndrome.

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LoE:IIIb³

GENERAL MEASURES

• Stop smoking.
• Limit alcohol intake.
• Eat small frequent meals.
• Avoid late night meals.
• Avoid fatty meals.
• Avoid carbonated beverages.
• Lose weight if overweight.
• Sleep with upper body elevated.
• Sleep on the left side.
• Stop the use of potential ulcerogenic medicines e.g. NSAIDs.
• If pale, check haemoglobin and refer if anaemic.

MEDICINE TREATMENT

• Proton-pump inhibitor e.g.:
• Pantoprazole, oral, 40 mg daily for a maximum of 14 days.
  • Also indicated for short-term use in pregnancy.
  • Refer if symptoms recur after 14-day course of therapy.

REFERRAL

• Presence of warning signs:
  • weight loss
  • anaemia
  • persistent vomiting
  • haematemesis
  • dysphagia
  • palpable abdominal mass
• No response within 7 days of starting proton-pump inhibitor therapy treatment.
• Recurrence of symptoms, especially:
  • > 50 years of age
  • previous gastric surgery
  • family history of gastric carcinoma

Click here to access the pdf.

Click here for the  NEMLC Recommendations for medicine amendments (2020-4 review cycle).

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Standard Treatment Guidelines And Essential Medicines List For South Africa, Primary Healthcare, 2020-4_Version 1_June 2024

Chapter 2: Gastro-intestinal Conditions, 2.2 Dyspepsia, Heartburn and Indigestion, in Adults