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Dyspepsia and GORD (adult primary care)

A Canadian clinical summary of dyspepsia and gord (adult primary care), with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by ACG and CAG Clinical Guideline: Management of Dyspepsia. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:CAG dyspepsia

Source-attributed clinical priorities

  • Assess dysphagia, bleeding, anemia, weight loss, vomiting, family history, medicine exposure and gastric-cancer risk before empiric care.
  • Use the CAG age- and risk-informed pathway for endoscopy, Helicobacter pylori testing and acid suppression.
  • Review response and step down unnecessary long-term acid suppression while escalating progressive dysphagia or bleeding urgently.
  • Progressive dysphagia is an alarm feature and should not be managed as uncomplicated reflux.
sources for this section:CAG dyspepsia

Practical assessment and management workflow

1
Characterize epigastric pain, heartburn, regurgitation, swallowing, bleeding, weight and medication exposure.
2
Assess age and cancer risk and test for Helicobacter pylori or arrange endoscopy through the CAG pathway.
3
Use a time-limited acid-suppression or eradication plan tied to the working diagnosis.
4
Confirm eradication when indicated and step down long-term proton-pump inhibition when no continuing indication remains.
sources for this section:CAG dyspepsia

Safety, red flags and urgent escalation

  • Hematemesis, melena, hemodynamic compromise or food-bolus obstruction needs urgent care.
  • Anemia, persistent vomiting, progressive dysphagia or unexplained weight loss requires expedited investigation.
  • Review magnesium, B12, fracture, kidney and infection context when long-term acid suppression continues.
sources for this section:CAG dyspepsia

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:CAG dyspepsia

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:CAG dyspepsia

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Canadian Association of GastroenterologyACG and CAG Clinical Guideline: Management of Dyspepsiaaccessed 2026-08-20
    view source
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