This month's quiz asks readers to determine the most appropriate next step in management for a 55-year-old man with a 2-day history of mild nausea and dyspepsia ... A 55-year-old man is evaluated in the emergency department for a 2-day history of mild
Researchers reviewed 15 randomized controlled trials involving 6,162 adults that assessed the effectiveness of management strategies for uninvestigated dyspepsia. ... Dyspepsia, however defined, is a frequent reason for consultation with primary care
in the treatment of functional dyspepsia is a trial of a tricyclic antidepressant. ... In the treatment of functional dyspepsia, this class of antidepressants was found to be more effective than other classes, including selective serotonin reuptake
found. Acupuncture increased response rate and elimination rate of all three cardinal symptoms of postprandial distress syndrome, the most common subtype of functional dyspepsia, a small study found.
The guidelines note that these endoscopies may be performed for reasons including workup of endoscopically identified gastropathy/presumed gastritis, evaluation of dyspepsia, or exclusion of Helicobacter pylori infection.
A barium esophagogram would have limited utility in this patient with dyspepsia and no associated symptoms consistent with esophageal disease, such as acid brash, dysphagia, and odynophagia.