Page 134 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

• Difficulty or pain swallowing (dysphagia), persistent vomiting, blood in vomit or stools (tar-
black stools).
• Signs of possible serious underlying disease: unexplained anaemia, palpable mass, GI
bleeding, persistent severe pain, or if symptoms persist despite self-care and OTC use.
• If the patient is on medications known to cause or worsen dyspepsia (e.g., chronic NSAIDs)
and symptoms are significant.
• When there’s a suspicion of complication (e.g., peptic ulcer, malignancy, gastroparesis) or
other GI conditions.
• If symptom pattern is not consistent with simple dyspepsia (e.g., pain radiating to back,
severe night sweats, unexplained weight loss) — require referral.

Non-Pharmacological Treatment
Advise lifestyle and dietary modifications: Eat smaller, more frequent meals rather than large
heavy meals.
Avoid known dietary triggers: fatty/greasy foods, spicy foods, carbonated drinks, excessive
caffeine/alcohol.
Avoid eating just before going to bed; allow 2-3 hours between last meal and lying down.
Elevate head of bed if symptoms worsen at night (if reflux component).
Avoid smoking and reduce alcohol; encourage weight loss if patient is overweight/obese.
Encourage stress-reduction techniques (since stress can exacerbate functional dyspepsia).
Chew food thoroughly, eat at a relaxed pace; avoid swallowing excessive air/burping.

Pharmacist’s role: counsel on realistic expectations of lifestyle change, give printed/digital
material or discuss helpful tips, support adherence to lifestyle plan. Note also that pharmacist-
advice can improve outcomes in dyspepsia self-care.

Pharmacological Treatment
• For mild / self-care appropriate dyspepsia, OTC options may include: Antacids (neutralize
stomach acid) for quick symptomatic relief (occasional use).

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