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Dyspepsia and gastro-oesophageal reflux disease

Everything NICE has said on investigating and managing dyspepsia and gastro-oesophageal reflux disease in an interactive flowchart

NICE Pathway Published September 2014 Last updated July 2017

Specialist investigation:- What specialist investigations should be conducted to exclude a diagnosis of functional dyspepsia in people with uninvestigated dyspepsia that does not respond to PPIs or H2 receptor antagonists (H2RAs) despite optimum primary care?

Recommendation ID CG184/5 Question Specialist investigation:- What specialist investigations should be conducted to exclude a diagnosis of functional...

Research recommendation Published June 2015

Suspected cancer recognition and referral

Everything NICE has said on suspected cancer, recognition and selection for referral or investigation in primary care in an interactive flowchart

NICE Pathway Published June 2015 Last updated July 2017

Dyspepsia: Management of dyspepsia in adults in primary care (CG17)

This guidance has been updated and replaced by gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

Clinical guideline Published August 2004 Withdrawn

The clinical and cost effectiveness of proton pump inhibitors for the treatment of dyspepsia (TA7)

This guidance has been updated and replaced by gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management

Technology appraisal guidance Published July 2000 Withdrawn

Idiopathic pulmonary fibrosis in adults: diagnosis and management (CG163)

Evidence-based recommendations on diagnosing and managing idiopathic pulmonary fibrosis (IPF) (hardening of the lungs) in adults

Clinical guideline Published June 2013 Last updated May 2017

Non-Hodgkin’s lymphoma: diagnosis and management (NG52)

Evidence-based recommendations on diagnosing and managing non-Hodgkin's lymphoma in people aged 16 years and over

NICE guideline Published July 2016

Do not use office-based serological tests for H pylori because of their inadequate performance.

Interventions: Office-based serological tests Source guidance details Guidance: Dyspepsia and gastro‑oesophageal reflux disease:...

Do not do recommendation Published June 2015

Barrett's oesophagus: ablative therapy (CG106)

Evidence-based recommendations on care and treatment of adults having ablative therapy to treat Barrett’s oesophagus with high-grade dysplasia…

Clinical guideline Published August 2010

Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation (TA249)

Evidence-based recommendations on dabigatran etexilate (Pradaxa) for preventing stroke and systemic embolism in atrial fibrillation (AF)

Technology appraisal guidance Published March 2012

Endoscopic augmentation of the lower oesophageal sphincter using hydrogel implants for the treatment of gastro-oesophageal reflux disease (IPG222)

Evidence-based recommendations on endoscopic augmentation of the lower oesophageal sphincter using hydrogel implants for gastro-oesophageal reflux

Interventional procedures guidance Published June 2007

Catheterless oesophageal pH monitoring (IPG187)

Evidence-based recommendations on catheterless oesophageal pH monitoring (placing small wireless capsule in gullet to check the level of acid)

Interventional procedures guidance Published July 2006

Laparoscopic fundoplication compared with medical management:- What is the effectiveness of laparoscopic fundoplication compared with medical management in people with GORD that does not respond to optimal proton pump inhibitor (PPI) treatment?

Source guidance details Comes from guidance Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management...

Research recommendation Published June 2015

Office-based serological tests for H. pylori cannot be recommended because of their inadequate performance.

Interventions: office-based serological tests Source guidance details Guidance: Dyspepsia (CG28) Published date: August 2004 Paragraph...

Do not do recommendation Published June 2015

Other specialist management:- What specialist management is effective for people whose symptoms do not respond to PPIs despite optimum primary care, or for people whose symptoms return after surgery?

Source guidance details Comes from guidance Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management...

Research recommendation Published June 2015

Surgery cannot be recommended for the routine management of persistent gastro-oesophageal reflux disease (GORD).

Interventions: surgery Source guidance details Guidance: Dyspepsia (CG17) Published date: August 2004 Paragraph number: 1.6.6 Page...

Do not do recommendation Published June 2015

Re-testing for H. pylori should be performed using a carbon-13 urea breath test. (There is currently insufficient evidence to recommend the stool antigen test as a test of eradication.)

Interventions: stool antigen test Source guidance details Guidance: Dyspepsia (CG17) Published date: August 2004 Paragraph number: 1.6.2...

Do not do recommendation Published June 2015

Patients testing positive for H. pylori should be offered eradication therapy. Re-testing after eradication should not be offered routinely.

Interventions: eradication therapy re-testing Source guidance details Guidance: Dyspepsia (CG17) Published date: August 2004 Paragraph...

Do not do recommendation Published June 2015

Long-term, frequent dose, continuous prescription of antacid therapy is inappropriate and only relieves symptoms in the short term rather than preventing them.

Interventions: antacid therapy Source guidance details Guidance: Dyspepsia (CG17) Published date: August 2004 Paragraph number: 1.8.7...

Do not do recommendation Published June 2015

ESUOM13: Gastroparesis in adults: oral erythromycin

Summary of the evidence on oral erythromycin for gastroparesis (delayed stomach emptying) in adults to inform local NHS planning and decision-making

Evidence summary Published June 2013

ESUOM22: Bile acid malabsorption: colesevelam

Summary of the evidence on colesevelam for treating bile acid malabsorption (BAM) to inform local NHS planning and decision-making

Evidence summary Published October 2013

ESUOM18: Promoting tolerance of enteral feeds in children and young people: domperidone

Summary of the evidence on domperidone to promote tolerance of enteral feeds in children and young people..

Evidence summary Published July 2013 Last updated September 2014

Laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease (IPG585)

Evidence-based recommendations on laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease (GORD) in adults

Interventional procedures guidance Published July 2017

ESUOM12: Generalised anxiety disorder: quetiapine

Summary of the evidence on quetiapine monotherapy for treating generalised anxiety disorder (GAD) to inform local NHS planning and decision-making

Evidence summary Published May 2013

MIB31: Peptest for diagnosing gastro‑oesophageal reflux

Advice on the use of the Peptest for diagnosing gastro-oesophageal reflux disease (GORD) to aid local decision-making

Medtech innovation briefing Published May 2015

Shared learning awards previous winners and finalists

Read more about our 2015 winner Finalists Dorset County Hospital NHS Foundation Trust - Improving care through complaints REACH Domestic Abuse...

Published March 2017

Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (CG68)

Evidence-based recommendations on the diagnosis and initial management of stroke and transient ischaemic attack (TIA or ‘mini-stroke’) in over 16s

Clinical guideline Published July 2008 Last updated March 2017

Standards and Indicators

Quality standards referrals Title Status Principal area of focus Abdominal aortic aneurysm Referred Healthcare Acne Referred Healthcare Acute...

Published March 2016

Past appeals and decisions

Down to Rejected appeals Cancelled appeals Past appeals TA ID Appraisal Short title Appeal hearing date TA111 Alzheimer´s disease - donepezil,...

Published May 2017

ESUOM42: Digital ulcers: sildenafil

Summary of the evidence on sildenafil for managing digital ulcers to inform local NHS planning and decision-making

Evidence summary Published March 2015

Head and neck cancer (QS146)

Evidence-based statements to deliver quality improvements in assessing, diagnosing and managing head and neck cancer in young people and adults

Quality standard Published March 2017

Gastrointestinal conditions

Everything NICE has said on gastrointestinal conditions in an interactive flowchart

NICE Pathway Published November 2013 Last updated June 2017

MIB104: NaviCam for diagnosing gastrointestinal tract conditions

Advice on the use of NaviCam for diagnosing gastrointestinal (GI) tract and small bowel conditions to aid local decision-making

Medtech innovation briefing Published May 2017

ESNM69: Prevention of chemotherapy induced nausea and vomiting in adults: netupitant/palonosetron

Summary of the evidence on netupitant/palonosetron to prevent chemotherapy induced nausea and vomiting to inform local NHS planning and decision-making

Evidence summary Published March 2016

ESUOM23: Transient ischaemic attack: clopidogrel

Summary of the evidence on clopidogrel for treating transient ischaemic attack (TIA) to inform local NHS planning and decision-making

Evidence summary Published December 2013

ESUOM19: Schizophrenia: omega-3 fatty acid medicines

Summary of the evidence on omega-3 fatty acid medicines for treating schizophrenia to inform local NHS planning and decision-making

Evidence summary Published September 2013

Cerebral palsy in under 25s: assessment and management (NG62)

Evidence-based recommendations on diagnosing, assessing and managing cerebral palsy in children and young people under 25

NICE guideline Published January 2017