British Society of Gastroenterology guidelines for the evaluation and management of dyspepsia

Clinical Question

What are the latest evidence-based guidelines for the management of functional dyspepsia?

Bottom line

These generally thoughtful, evidence-based guidelines provide a helpful framework for evaluating and treating patients with dyspepsia. The guidance regarding imaging and the use of upper endoscopy is probably on the conservative side for US physicians. The authors acknowledge that approximately half of the recommendations are based on low- or very low–quality evidence. (LOE = 1a)

This POEM aligns with the Canadian Association of Gastroenterology's Choosing Wisely Canada recommendation: Avoid using an upper GI series to investigate dyspepsia.

Study design: Practice guideline

Funding: Foundation

Setting: Outpatient (any)


Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

Discuss this POEM



Impact assessment

Very good

Randall Reid Hurst




H. pylori in dyspepsia

Aggressive identification and treatment of H. pylori essential


No thanks

No thanks

Pieter Richard Verbeek

British Society of Gastroenterology guidelines for the evalu

Thanks for the review. While the POEM is not surprisingly, too general to apply to patients, it at least provides notice of an updated guideline that I will have to take a look at.


Tegaserod discontinued in US

Zelnorm (Tegaserod) has been discontinued by the manufacturer in the US. I am not sure if it is available in Canada.
It has many contraindications including any CAD and age over 65!
It looks like it is back to Metoclopramide as a pro kinetic.


Dyspepsia Guidelines

It would be helpful to have statistics on the medications as to their effectiveness, Tegaserod is not available

Mathews Manampuram

great topic relevant to family practice

surprisingly testing for H. Pylori first step, equally interesting the lack of evidence for FODMAPS diet. Would like to learn more about Prokinetics for dyspepsia and their role.