oa SA Pharmaceutical Journal - An approach to dyspepsia for the pharmacist : evidence-based pharmacy practice



Dyspepsia is a symptom, or a combination of symptoms, that indicates the presence of an upper gastrointestinal tract problem. Typical symptoms include epigastric pain or burning, early satiation and postprandial fullness, belching, bloating, nausea or discomfort in the upper abdomen. Most people with dyspepsia do not seek medical care for their symptoms, although 25% of the developed world's population suffers from dyspepsia annually. Rates range between 13-40% in different countries. Antacids remain safe, simple and effective agents for the symptomatic treatment of gastric acid-related symptoms. Evidence supports a test-and-treat approach in patients with non-dominant heartburn dyspepsia symptoms. In addition to antacids, dyspepsia is treated with proton-pump inhibitors (PPIs), H2 blockers or cytoprotective agents, for example, sucralfate. Prokinetic drugs, for example metoclopramide, domperidone and erythromycin, also have a role to play in the treatment of dyspepsia. All patients should be offered general treatment, including advice on self-treatment, lifestyle changes, patient empowerment, and the management of long-term symptoms. Pharmacists are well placed to provide counselling and support to people suffering from dyspepsia.


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