What are the recommended first-line treatments for dyspepsia in adults according to NICE guidelines?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Offer a full-dose proton pump inhibitor (PPI) for 4 weeks as initial empirical treatment for uninvestigated dyspepsia in adults .

Alternatively, test for Helicobacter pylori infection and treat a positive result with first-line eradication therapy, which includes a 7-day, twice-daily course of a PPI combined with amoxicillin and either clarithromycin or metronidazole .

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