Treatment

For patients who have uncomplicated dyspepsia, with no identified cause, people usually start off by being advised to change lifestyle.  This means usually reducing alcohol intake, stopping smoking, reducing spicy foods or other foods that give worse symptoms of dyspepsia.  Obviously if any nonsteroidal anti-inflammatory drugs are being taken, they should also be stopped. 

Traditional therapies have then been antacids (such as milk of magnesia) or drinking milk.  Unfortunately very little of these simple treatments have much effect. 

More effective drug treatments have been developed.  Initially drugs called H2 blockers were developed which reduced the acid output of the stomach and markedly improved the symptoms of dyspepsia in most people. These have now largely been replaced by proton pump inhibitors (PPI's) which completely stop all acid output from the stomach. 

These cure the dyspepsia and majority of people and allow any underlying erosions or ulcers to heal.  However, recurrence rates can be high.  Many studies have shown that if H. pylori is also eradicated by specific therapies of antibiotics at the same time, not only do these drugs cure the problem but the recurrence rates are far lower. 

Obviously if any malignancy or other condition is identified, the patient will be transferred to the appropriate specialist and the symptoms of dyspepsia become unimportant to treat until the malignancy or other condition is treated.