Empiric antacids and reassurance for acute dyspepsia.
The evaluation of ambulatory patients with dyspepsia frequently includes upper gastrointestinal radiographs (UGIs), a practice of unproven value in low-risk patients. To assess an alternative management strategy without UGIs, 28 patients with upper abdominal pain seen in an adult medical walk-in practice were treated with high-dose antacid therapy for three weeks. The clinical course on antacid therapy was good; 68% of patients reported substantial improvement. Initial requests for UGIs were high among both patients and physicians. Following empiric antacid therapy, requests for UGIs fell from 68% to 32% for patients (p = 0.05) and from 71% to 21% for physicians (p = 0.001). No serious complications were detected after 18 months of follow up. Direct medical charges were reduced by 37%. Empiric antacid therapy for patients at low risk for serious disease relieves dyspepsia and reduces both patient and physician requests for UGIs.
D000328:Adult; D000536:Aluminum Hydroxide / Q000627:therapeutic use*; D000863:Antacids / Q000627:therapeutic use*; D003363:Cost Control; D004338:Drug Combinations / Q000627:therapeutic use; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use*; D008276:Magnesium Hydroxide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011859:Radiography
D000863:Antacids; D004338:Drug Combinations; C013591:aluminum hydroxide, magnesium hydroxide, drug combination; D000536:Aluminum Hydroxide; D008274:Magnesium; D008276:Magnesium Hydroxide