CLINICAL FEATURES

• Patient usually presents with pain or discomfort felt to arise in the upper gastrointestinal (GI) tract with symptoms on greater than 25% of days over the past 4 weeks [1].
• Patients can have epigastric pain or discomfort, or nausea.
• Patients with symptoms every day for seven days are said to have dyspepsia[1]
• Alarm features should be sought in all patients presenting with dyspepsia. If alarm features are present, endoscopy should be performed. They include [1]
o Anemia
o Acute onset dysphagia
o Hematemesis
o Melena
o Persistent vomiting
o Weight loss greater than 5% (involuntary)
o Other alarm features include family history of upper gastrointestinal cancer, gastrointestinal bleeding, odynophagia, persistent vomiting, palpable mass or lymphadenopathy and jaundice [7]

• If patient has dyspepsia, elicit a detailed history to identify patients whose symptoms may be attributable to medication use, gastroesophageal reflux disease, gallstone
• If patient has dyspepsia, they should be asked about other physical problems, coexisting psychological symptoms, and stressful life events, because these factors influence the severity of the illness and affect its management
SIGNS

• If patient has dyspepsia, they should undergo a physical examination for tenderness, which is usually nonspecific