A 55-year-old man presents with epigastric pain related to meals and night-time waking. He takes Ibuprofen regularly for back pain. There are no alarm...

Question

A 55-year-old man presents with epigastric pain related to meals and night-time waking. He takes Ibuprofen regularly for back pain. There are no alarm symptoms. What is the most appropriate initial management in primary care?

Accepted Answer

Start a proton pump inhibitor and review response, while considering stopping NSAIDs

Answer

Immediate upper GI endoscopy

Answer

Start long-term H2-receptor antagonist without further assessment

Answer

Test and treat for Helicobacter pylori without stopping NSAIDs

Answer

Provide reassurance only

uk-plab-1 MCQ (SBA): Dyspepsia – initial management

A 55-year-old man presents with epigastric pain related to meals and night-time waking. He takes Ibuprofen regularly for back pain. There are no alarm symptoms. What is the most appropriate initial management in primary care?