An Algorithm for Management of Patients with Dyspepsia - Flowchart

An Algorithm for Management of Patients with Dyspepsia - Flowchart

An Algorithm for Management of Patients with Dyspepsia - Flowchart Dyspepsia, Nonulcerative Dyspepsia, Nonulcerative

«Flowchart»

Uninvestigated dyspepsia

Uninvestigated dyspepsia

Uninvestigated dyspepsia

Uninvestigated dyspepsia

Empirical therapy:

“Test and treat”
PPI
Consider prokinetic agent

Empirical therapy:

Empirical therapy:

“Test and treat”
PPI
Consider prokinetic agent

“Test and treat”
PPI
Consider prokinetic agent Empirical therapy

Endoscopy

Endoscopy

Endoscopy

No response

No response

No response

Functional dyspepsia

Functional dyspepsia

Functional dyspepsia

Functional dyspepsia

Organic dyspepsia
Peptic ulcer
Esophagitis
Celiac disease
Giardiasis
Pancreatitis
Biliary disease
Others

Organic dyspepsia
Peptic ulcer
Esophagitis
Celiac disease
Giardiasis
Pancreatitis
Biliary disease
Others

Organic dyspepsia
Peptic ulcer
Esophagitis
Celiac disease
Giardiasis
Pancreatitis
Biliary disease
Others

Organic dyspepsia

Endoscopy

Endoscopy

Endoscopy

70%

70%

70%

30%

30%

30%

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

^* ^*
_1A

Acid suppressive therapy

Acid suppressive therapy

Acid suppressive therapy

Acid suppressive therapy

Acid suppressive therapy

Acid suppressive therapy

Antidepressant, if symptoms refractory

Antidepressant, if symptoms refractory

Antidepressant, if symptoms refractory

End

End

End

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

Prokinetic agent
Acotiamide^*
5-HT_1A agonist

^* ^*
_1A

70%

70%

70%

30%

30%

30%

^* Not available in the U.S.

^* Not available in the U.S.

^* Not available in the U.S.

^*

5-HT, 5-hydroxytryptamine; PPI, proton pump inhibitor

5-HT, 5-hydroxytryptamine; PPI, proton pump inhibitor

5-HT, 5-hydroxytryptamine; PPI, proton pump inhibitor

5-HT PPI

Eradicate if positive for Helicobacter pylori and not already treated

Eradicate if positive for Helicobacter pylori and not already treated

Eradicate if positive for Helicobacter pylori and not already treated

Helicobacter pylori Helicobacter pylori

Postprandial distress syndrome

Postprandial distress syndrome

Postprandial distress syndrome

Epigastric pain syndrome

Epigastric pain syndrome

Epigastric pain syndrome