Dyspepsia Clinical Practice Guidelines (BSG, 2022)

British Society of Gastroenterology

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

August 09, 2022

Guidelines on the diagnosis and treatment of dyspepsia were published in July 2022 by the British Society of Gastroenterology in Gut .[1] Selected strong recommendations are noted below.

Functional dyspepsia is the underlying cause of symptoms in most patients with dyspepsia who have undergone evaluation.

When upper gastrointestinal (GI) red-flag symptoms/signs are not present or reported:

  • Diagnose functional dyspepsia when bothersome epigastric pain or burning, early satiation, and/or postprandial fullness exist for longer than 8 weeks.

  • Urgent endoscopy is only warranted in those aged 55 years or older who have dyspepsia with weight loss, or those older than 40 years who are from an area with a heightened risk of gastric cancer or who have a family history of gastroesophageal cancer.

Obtain a full blood count in those aged 55 years or older who have dyspepsia. Obtain celiac serology in all patients with functional dyspepsia who have overlapping irritable bowel syndrome-type symptoms.

Consider nonurgent endoscopy in individuals at least aged 55 years who have refractory dyspepsia or dyspepsia with either an increased platelet count or nausea/vomiting.

To rule out pancreatic cancer, consider obtaining urgent abdominal computed tomography (CT) imaging in individuals aged 60 years or older who have abdominal pain and weight loss.

Offer noninvasive Helicobacter pylori testing to all other patients with dyspepsia. With confirmation of H pylori infection, administer eradication therapy. Only confirm successful H pylori eradication following noninvasive testing in individuals who have a greater risk of gastric cancer.

Offer empirical acid suppression therapy to individuals not infected with H pylori.

Do not routinely perform gastric emptying testing or 24-hour pH monitoring in the setting of typical symptoms of functional dyspepsia.

For more information, please go to Helicobacter Pylori Infection, Gastroesophageal Reflux Disease, and Irritable Bowel Syndrome (IBS).


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