Treatment of Functional Dyspepsia in the Absence of Helicobacter pylori Infection
When a patient presents with functional dyspepsia and testing confirms no active Helicobacter pylori infection, the absence of this pathogen shapes the management strategy from the outset.
Clinical Scenario
This protocol applies to patients diagnosed with functional dyspepsia (ICD-11 DD90.3, ICD-10 K30) in whom Helicobacter pylori infection has been excluded. Without H. pylori as a treatable cause, the approach focuses on other evidence-based interventions specific to this sub-population.
Treatment Approach (Overview)
First-line management in H. pylori-negative functional dyspepsia includes lifestyle-based measures — specifically, guidance on regular aerobic exercise and avoidance of individual dietary triggers.
The complete evidence-based regimen, including additional therapeutic options and the full clinical algorithm, is available in the structured protocol below.
References
DOI: 10.1136/gutjnl-2022-327737
- We recommend that patients without H. pylori infection are offered empirical acid suppression therapy (recommendation: strong; quality of evidence: high).
- We recommend that all patients with FD are advised to take regular aerobic exercise (recommendation: strong, quality of evidence: very low).
- Triggers may include spicy food or alcohol, for example, but there is insufficient evidence to recommend specific dietary therapies, including a diet low in fermentable oligosaccharides, di- and monosaccharides, and polyols in FD.
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