NICE GORD guideline
A brief NICE guidance summary on the investigation and management of dyspepsia and GORD including H pylori testing and eradication, and endoscopy referral.
Dyspepsia is any upper gastrointestinal symptom present for 4 weeks or more, including upper abdominal pain or discomfort, heartburn, acid reflux, nausea or vomiting. Dyspepsia occurs in 40% of the population and accounts for 4% of yearly primary care consultations. Causes of dyspepsia include gastro-oesophageal reflux disease (GORD), oesophagitis and oesophageal or gastric cancers, but cases are most commonly due to unknown functional dyspepsia. GORD symptoms include heartburn, acid reflux and oesophagitis; this can lead to Barrett’s oesophagus and risk of oesophageal adenocarcinoma, diagnosed by endoscopy. Determining which patients to refer for endoscopy is an important role for primary care.
This Guidelines for Nurses summary contains recommendations for assessing dyspepsia, including risk factors for GORD, when to test for and treat h.pylori, and treatment of peptic ulcer disease and functional dyspepsia. It includes flowcharts of referral criteria and subsequent management, and interventions for dyspepsia and GORD.