QuestionSBA
QuestionChoice
NICE clinical guideline CG184 states dyspepsia in unselected people in primary care is defined broadly to include people with recurrent epigastric pain, heartburn or acid regurgitation, with or without bloating, nausea or vomiting. They state to offer H pylori 'test and treat' to people with dyspepsia.
10005321
a
Stool antigen test for Helicobacter pylori (H. pylori) infection
QuestionChoice
This investigation is not used in the work-up for dyspepsia. It is often the first imaging test used to evaluate and diagnose the source of acute pain in the abdominal region and/or lower back as well as unexplained nausea and vomiting.
10005324
d
Abdominal X-ray
QuestionChoice
The test is commonly performed in people who have difficulty swallowing, a sensation of food being “stuck”, or pain on swallowing. Indigestion or dyspepsia are rarely indications, but would not be considered before H. pylori is ruled out and is not favoured over endoscopy.
10005325
e
Barium swallow
QuestionChoice
There are no red flags in this case as yet to merit an endoscopy and certainly a H. pylori test would be first-line before invasive endoscopy is considered. In this patient, a full-dose proton pump inhibitor for four to eight weeks should also be trialled before considering endoscopy.
10005322
b
Upper GI endoscopy
QuestionChoice
This investigation has no place in the work-up for dyspepsia. It is often used to visualise the kidneys, liver, gallbladder, bile ducts, abdominal aorta and pancreas.
10005323
c
USS Abdomen
Concept
Chapter
2693
4019
H. Pylori
Topic
136
Gastroenterology
13611
A 52-year-old woman is seen in the General Practice surgery. She complains of progressive upper abdominal pain and heartburn for the last month despite lifestyle changes. This is the second time she has presented to her GP with this complaint. She is currently taking no medication and denies nausea and vomiting or weight loss. Her abdominal examination is unremarkable.

Which of the following is the next best investigation?
a