Dyspepsia DDx

Dyspepsia – Differential Diagnosis

Common causes

• GORD
• Non ulcer dyspepsia
• Peptic ulcer disease
• Gall stone disease

Must Not Miss

• Angina/ MI
• Malignancy
  • Oesophageal cancer
  • Gastric Cancer
  • Pancreatic Cancer
• Pancreatitis
• Cholecytitis/ Cholangitis
• Intestinal obstruction

Easily missed

• Medication
• Alcohol
• Food allergy
• Diabetic Gastroparesis

Red flags

• Cardiac symptoms
• New onset persistent Dyspepsia > 50 years old
• Dysphagia
• Persistent vomiting
• Haematemesis/ Melaena
• Weight loss
• Systemic features (fever, night sweats, anorexia)
• Abdominal swelling/mass
• Supraclavicular lymph nodes
• Past history of cancer
• Family history of cancer
• Iron deficiency Anaemia

Investigations to consider

• FBC, CRP/ ESR
• U&Es, LFTs, Blood glucose, Bone profile
• Serum amylase
• Coeliac screen
• H pylori test
• Pregnancy test
• ECG
• OGD
• USS
• CT