What pharmacological treatments are recommended for managing symptoms of functional dyspepsia in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Pharmacological treatments recommended for managing symptoms of functional dyspepsia in primary care include:

  • Empirical full-dose proton pump inhibitor (PPI) therapy for 4 weeks is recommended as first-line treatment for dyspepsia symptoms.
  • If symptoms persist or there is an inadequate response to PPI therapy, H2 receptor antagonist (H2RA) therapy can be offered as an alternative.
  • After initial symptom control, step down PPI therapy to the lowest effective dose and consider 'as-needed' use to manage symptoms.
  • Encourage patients to return to self-treatment with antacid and/or alginate therapy, either prescribed or over-the-counter, for symptom relief unless there is an underlying condition requiring ongoing treatment.

These recommendations are based on NICE guideline CG184 for gastro-oesophageal reflux disease and dyspepsia in adults, which applies to primary care management of dyspepsia symptoms .

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