Dyspepsia
In a patient presenting with dyspepsia, include cardiovascular disease in the differential diagnosis.
Attempt to differentiate, by history and physical examination, between conditions presenting with dyspepsia (e.g., gastroesophageal reflux disease, gastritis, ulcer, cancer), as plans for investigation and management may be very different.
In a patient presenting with dyspepsia, ask about and examine the patient for worrisome signs/symptoms (e.g., gastrointestinal bleeding, weight loss, dysphagia).
General Overview
Definition: One of the following symptoms - Postprandial fullness, early satiation, epigastric pain
Precipitating factors: NSAID/ASA, smoking, alcohol, high fat meals
H pylori associated with dyspepsia (but treatment does not necessarily improve symptoms)
Incidence 20-40% in Canada, higher in First Nations (>50%), lower in children born in Canada.
Risk of ulcer (10-20% vs. 1-2%) and gastric cancer (33% relative reduction)
Ddx
Functional/IBS (no organic cause) - 60%
PUD - 25%
Upper abdominal pain prominent, back pain atypical
Gastric worse with food, Duodenal better with food
Postprandial belching, epigastric fullness, early satiation, N/V
GERD
Retrosternal pain/regurgitation
GI Malignancy
Age
Dysphagia, odynophagia
Systemic signs (anemia, fatigue, weight loss)
Drug-induced dyspepsia (NSAIDs and COX-2 inhibitors)
Other: Celiac, chronic pancreatitis, gastritis, Crohn's, cardiac
Red Flags (VWBAAAD)
Vomiting
Weight Loss (Involuntary)
Blood loss (melena, hematemesis, anemia)
Age >50
Anemia
Abdominal mass or lymphadenopathy
Dysphagia, odynophagia, early satiety
Family history of upper GI cancer
Note for chest pain, r/o CAD
Physical Exam
Carnett's sign: Abdominal tenderness on muscle tensing (positive test), suggests abdominal wall pain rather than viscera
Lymphadenopathy (left supraclavicular, periumbilical)
Palpable abdominal mass (hepatoma), jaundice (liver mets), pallor (anemia)
Investigations
Consider CBC r/o anemia if hx of GI bleed
H Pylori
Urea breath test (stop PPI 2w prior to test, antacids PRN)
Consider in <50yo with dyspepsia but no red flags (especially if family history of peptic ulcer or cancer)
Note: Not necessary to screen nonulcer dyspepsia with GERD prominent symptoms (heartburn/regurgitation)
Stool antigen test can be considered if UBT not available
IgG antibody testing helpful if negative (but does not distinguish cleared infection if positive)
Could be acceptable in documented PUD given high pretest probability
Endoscopy if
>50yo with new-onset dyspepsia
Atypical features or red flags
No response (or limited) after 4-8w of adequate PPI
Consider in chronic GERD with 3 risk factors for Barrett's esophagus (male > 50 years old, Caucasian, central obesity, smokers and family history of BE)
Treatment
Lifestyle
Weight loss if overweight
Stop smoking, excessive alcohol
Stop NSAID/ASA
Avoid food/drinks that trigger (Alcohol, fried foods, spicy foods, garlic/onion, orange/citrus, chocolate/peppermint, coffee/caffeine, tomatoes)
Eat smaller meals
Elevate head of bed, avoid meal 2-3h before bedtime if nocturnal GERD
Mild (<3 episodes/week, low intensity, short duration)
Alginates, antacids, low-dose H2 receptors-antagonist
Reassess after 1 month
Moderate/Severe
Rabeprazole (Pariet) 20mg PO daily x 4-8w
Reasssess in 4-8w
If good response, trial of D/C (20% remain asymptomatic, consider antacid or H2 Blocker PRN)
If symptoms relapse
Return to previous PPI dose, can prescribe on-demand (take during periods needed)
Inadequate can try to double dose, BID, or switch PPI
Reassess in 4w
Endoscopy if no response after adequate trial
Longterm
Attempt to stop/reduce PPI yearly (except in Barrett's, esophagitis, or GI bleed), consider H2 blocker maintenance
Risks of PPI
Hip fracture (0.4% vs. 0.18%)
C Diff (OR 1.96)
Pneumonia (OR 1.73, NNH 226)
Low: Vit B12, iron, magnesium, calcium, parathyroid
Consider endoscopy if requires >10y of treatment r/o Barrett's esophagus
H pylori
Risk
Low SES
Number of siblings
Infected parents (mother)
Born outside North America (immigrants)
Indications for Testing
Dyspepsia (consider endoscopy if >50yo or alarm features)
GERD-prominent symptoms do not require testing
Active/previous peptic ulcer disease
Low-grade gastric mucosa-associated lymphoid tissue lymphoma (MALT) or history of gastric cancer resection, or family history of gastric cancer
Longterm NSAIDs
H pylori Management
If clarithromycin resistance rates known to be <15% (and in patients without previous macrolide exposure) or proven high local eradication rates >85%
Note: From a study in 2000 by Fallone, primary resistance to H pylori in Canada is estimated to be approximately 20% for metronidazole and 1-4% for clarithromycin
Standard Triple Therapy (PAC) x 14d
PPI, eg. Lansoprazole 30mg PO BID
Amoxicillin 1g PO BID
Clarithromycin 500mg PO BID
In areas of clarithromycin resistance:
Non-Bismuth Quadruple (PAMC) x 14d
PPI, eg. Lansoprazole 30mg PO BID
Amoxicillin 1g PO BID
Metronidazole 500mg PO BID
Clarithromycin 500mg PO BID
If allergy to penicillin, or failure of standard therapy:
Bismuth quadruple therapy (PBMT) x 14d
PPI BID
Bismuth subsalicylate 524mg (or 30mL) QID
Metronidazole 250mg QID
Tetracycline 500mg QID
Confirm eradication if
ACG 2017 recommends testing all patients ≥ 4 weeks after antibiotic completed and 1-2 weeks after proton pump inhibitor (PPI) withheld
Symptomatic after treatment (UBT after 28d of antibiotic, 3d PPI)
H. pylori positive gastric/duodenal ulcer or gastric cancer (endoscopy)
Peptic Ulcer Disease
Diagnosis
Suspect in dyspepsia with chronic NSAID use
Definitive diagnosis by upper endoscopy
Rule out complications
Bleeding
Gastric outlet obstruction
Perforation
Eradication of H pylori
Confirm eradication >4w after completion of therapy
Stop/avoid
Smoking, alcohol
NSAIDs
Foods that cause symptoms (although no evidence that foods increase the risk of ulcers)
PPI
If H pylori-positive ulcer, consider short 14-day course along with H pylori treatment, as most (>90%) heal without PPI and as effective as 4w PPI
In complicated ulcer consider 8 week course (or after confirming ulcer healing by endoscopy)
NSAID-induced ulcer consider 8 week course (or longer if continued NSAID use)
Consider maintenance PPI in the following cases
Refractory peptic ulcer
H pylori-negative and NSAID-negative ulcer
>2cm ulcer and comorbidities
Frequent peptic ulcers (>2 per year)
Continued NSAID use
References:
Dyspepsia
GERD
Canadian Association of Gastroenterology GERD Consensus Group 2005. https://www.cag-acg.org/images/publications/GERD_Consensus_Update_2004.pdf
Helicobacter pylori
ACG Guideline 2017. http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf
Gastroenterology 2016. The Toronto Consensus. https://www.cag-acg.org/images/publications/Hp_Toronto_Consensus_2016.pdf
AAFP 2015. http://www.aafp.org/afp/2015/0215/p236.html
Can J Gastroenterol 2000. https://www.ncbi.nlm.nih.gov/pubmed/11111111
PPI
Choosing Wisely Canada 2016. http://www.choosingwiselycanada.org/wp-content/uploads/2016/04/CWC_PPI_Toolkit_v1.0_2016-03-31.pdf
Rx Files 2015. http://www.rxfiles.ca/rxfiles/uploads/documents/PPI-Deprescribing-Newsletter.pdf