Indigestion

Question 1

What are the causes of indigestion?

Answer 1

• GORD
• Oesophagitis
• H pylori
• Duodenal ulcer
• Gastritis
• Gastric ulcer
• Gastric malignancy
• Duodenitis

Question 2

What are the red flag symptoms of indigestion?

Answer 2

• ALARMS
• Anaemia
• Loss of weight
• Anorexia
• Recent onset
• Melena
• Swallowing different

Question 3

How should indigestion be investigated?

Answer 3

• Test for H pylori - urease breath test
• Upper GI endoscopy - look for ulcers
• Gastric biopsy - histology for H pylori
• eCXR - pneumoperitoneum

Question 4

What are the signs and symptoms of indigestion?

Answer 4

• Retrosternal burning and chest pain
• Epigastric pain, typically before meals and at night (relived by eating/drinking milk)
• Epigastric tenderness
• Weight loss

Question 5

How should indigestion be managed?

Answer 5

• Reduce acidPPI
• H pylori eradication if they have it
  
  • PPI with clarithromycin and amoxicilin or if penicilin allergy metronidazole
• Stop drugs that induce ulcers such as NSAIDs