Initial management of dyspepsia in primary care: an evidence-based approach.

498 British Journal of General Practice, September 2013 INTRODUCTION The word dyspepsia derives its origin from the Greek work dyspeptos, which means ‘bad digestion’. The term is used to describe symptoms thought to be referable to the upper gastrointestinal (GI) tract. Which symptoms to include in the definition of dyspepsia is controversial, but upper abdominal pain or discomfort, bloating, fullness, early satiety, heartburn, and regurgitation may be considered part of the symptom complex. Potential aetiologies range from the benign (such as functional dyspepsia, where there is no structural cause found to explain the symptoms) to the lifethreatening (gastro-oesophageal cancer). Other common underlying organic causes of dyspepsia include peptic ulcer disease and gastro-oesophageal reflux disease. Dyspepsia represents a considerable burden to the health service, and therefore optimal management of the condition in primary care is essential. This article aims to provide the reader with an update on evidence that supports current guidelines for the initial management of dyspepsia in primary care.