Urgent

All patients who've got dysphagia

All patients who've got an upper abdominal mass

consistent with stomach cancer

Patients aged >= 55 years who've got weight loss, AND any of the following:

• upper abdominal pain
• reflux
• dyspepsia

Non-urgent

Patients with haematemesis

Patients aged >= 55 years who've got:

• treatment-resistant dyspepsia or
• upper abdominal pain with low haemoglobin levels or
• raised platelet count with any of the following: nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain
• nausea or vomiting with any of the following: weight loss, reflux, dyspepsia, upper abdominal pain

Managing patients who do not meet referral criteria ('undiagnosed dyspepsia')

This can be summarised at a step-wise approach

• 1. Review medications for possible causes of dyspepsia
• 2. Lifestyle advice
• 3. Trial of full-dose proton pump inhibitor for one month OR a 'test and treat' approach for H. pylori
  • if symptoms persist after either of the above approaches then the alternative approach should be tried