Med. praxi. 2026;23(4):235-242 | DOI: 10.36290/med.2026.035

Patient with dyspepsia in general practice

MUDr. Jan Šťovíček, Ph.D.

Interní klinika FNMH a 2. LF UK, Praha

Klinika Restrial, Praha

Dyspepsia is a common clinical problem in primary care. The key task is to distinguish low-risk patients suitable for an empirical management strategy from those with alarm features or an increased risk of organic disease, in whom prompt diagnostic evaluation is indicated. Functional dyspepsia most commonly presents with postprandial fullness, early satiety, epigastric pain, or epigastric burning and may have a substantial impact on quality of life. The diagnostic approach is based on a careful medical history, physical examination, medication review, and appropriately targeted laboratory, imaging, and endoscopic investigations. In low-risk patients, treatment may be selected empirically according to the predominant symptom phenotype. In patients with alarm features, further diagnostic evaluation should not be delayed. For patients with a pain- or burning-predominant phenotype, a time-limited therapeutic trial of a proton pump inhibitor is appropriate, whereas lifestyle and dietary measures and prokinetic agents may be considered in patients with postprandial fullness, early satiety, and nausea. Treatment response should be reassessed within a short interval, and the diagnosis should be reconsidered in cases of treatment failure, symptom progression, or the development of alarm features.

Keywords: dyspepsia, functional dyspepsia, postprandial distress syndrome, epigastric pain syndrome, proton pump inhibitors, prokinetic agents.

Received: July 24, 2026; Revised: August 31, 2026; Accepted: August 31, 2026; Published: October 14, 2026  Show citation