What pharmacological treatments are recommended for managing symptoms of functional dyspepsia in primary care?

Pharmacological treatments recommended for managing symptoms of functional dyspepsia in primary care include:

• Empirical full-dose proton pump inhibitor (PPI) therapy for 4 weeks is recommended as first-line treatment for dyspepsia symptoms.
• If symptoms persist or there is an inadequate response to PPI therapy, H2 receptor antagonist (H2RA) therapy can be offered as an alternative.
• After initial symptom control, step down PPI therapy to the lowest effective dose and consider 'as-needed' use to manage symptoms.
• Encourage patients to return to self-treatment with antacid and/or alginate therapy, either prescribed or over-the-counter, for symptom relief unless there is an underlying condition requiring ongoing treatment.

These recommendations are based on NICE guideline CG184 for gastro-oesophageal reflux disease and dyspepsia in adults, which applies to primary care management of dyspepsia symptoms ¹.