Question

A 29-year-old woman presents with 3 months of episodic epigastric pain relieved by food, with no alarm features. She takes NSAIDs occasionally for headaches. According to dyspepsia management guidelines, what is the MOST appropriate initial strategy?

Accepted Answer

Empiric proton pump inhibitor therapy and test for Helicobacter pylori

Answer

Immediate upper endoscopy for all patients under 60

Answer

Start long-term H2-receptor antagonist alone

Answer

Test for H. pylori and treat only if positive, no acid suppression

Answer

No treatment; symptoms are likely functional

Practice question

A 29-year-old woman presents with 3 months of episodic epigastric pain relieved by food, with no alarm features. She takes NSAIDs occasionally for headaches. According to dyspepsia management guidelines, what is the MOST appropriate initial strategy?