Patient Education

  • There is no clear evidence of specific association between lifestyle factors & dyspepsia, but some individuals may be helped by these measures
  • To reduce anxiety, in cases where there are no indications of organic disease, reassurance is an important part of initial therapy
  • Provide patients w/ access to educational materials to support the care they receive
Lifestyle Modifications
  • Advise patients to avoid known precipitants that they associate w/ dyspeptic symptoms eg alcohol, coffee, chocolate & fatty foods
    • Alcohol, coffee, & chocolate have pharmacological effects that may reduce the tone of the lower esophageal sphincter (LES)
    • Fatty foods delay gastric emptying time which may also predispose to GERD
  • Encourage patient to stop smoking
    • Smoking has pharmacological effects that may reduce the tone of the LES
  • Wt reduction for overweight & obese patients
    • Obesity may disrupt the LES due to mechanical pressure on the diaphragm
  • May suggest having a main meal well before going to bed (preferably 3 hr before)
  • Some patients may benefit from raising the head when sleeping
    • Lying flat may increase reflux episodes since gravity does not prevent acid regurgitation
Other Considerations
  • If there is concurrent use of NSAIDs, evaluate for risk of GI complications & consider alternative strategies if risk is a concern
    • See PUD Management Chart for details
  • Patients w/ refractory functional dyspepsia have a high rate of accompanying depression & psychiatric illness
    • May consider psychological therapies, eg cognitive behavioral therapy (CBT) & psychotherapy, or antidepressants to reduce dyspeptic symptoms esp in non-ulcer dyspepsia