Questionnaire/history: Upper abdominal discomfort or pain or discomfort? Heartburn/acid reflux? Nausea and/or vomiting? Red flag symptoms? Characteristics of symptoms? - Onset? - Frequency? - Duration? - Pattern? - Trigger drinks/foods (eg coffee, chocolate, tomatoes, fatty or spicy food)? Eating pattern? - Missing meals? - Eating large meals? - Eating shortly before bed? Mental health problems? - Stress? - Anxiety? - Depression? PMH? - Obesity? FH? - Gastrointestinal malignancy? DH? Alcohol intake? Smoking? Examination: Weight (weight loss)? Anaemia? Abdomen? Management: Full-dose proton pump inhibitor (PPI) for 1 month OR Test for Helicobacter pylori infection Advised: - Antacids and/or alginates (eg Gaviscon Double Action Mint Oral Suspension) for short-term symptom control - To avoid trigger foods, such as coffee, chocolate, tomatoes, fatty or spicy foods - To eat smaller meals and eat evening meal 3-4 hours before going to bed if possible - To not smoke - To not drink more alcohol than recommended (14 units per week) - To lose weight if overweight - To reduce or stop any drugs that may cause or exacerbate symptoms (eg NSAIDs) - To seek medical advice if new or worsening symptoms (eg if worsening pain, persisting vomiting, feeling faint or fever) or on ongoing symptoms - To read NHS info about 'Indigestion' and 'Gastritis' - To arrange follow-up appointment refractory or recurrent symptoms Reference(s): NICE CKS: Dyspepsia - unidentified cause Information for patients/carers: NHS Health A to Z: Gastritis NHS Health A to Z: Indigestion Patient UK: Indigestion (Dyspepsia)