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Dyspepsia and GORD


Indigestion, also known as dyspepsia, is a condition of impaired digestion

New onset dyspepsia

Pre-referral investigations – test for Helicobacter pylori by Stool Antigen Test, -FBC and TTG

Pre-referral treatment – omeprazole for four weeks, if no alarm symptoms. One attempt at H.pylori eradication if Stool Antigen Test was positive, then repeat the faeces test and refer if still symptomatic.

Referral threshold – refer as Two Week Wait if persistent vomiting, weight loss, iron deficiency anaemia, previous gastric ulcer, previous gastric surgery OR routine referral if failure of medical management

Recurrent dypsepsia

Pre-referral investigations – test for Helicobacter pylori by Stool Antigen Test

Pre-referral treatment – one attempt at eradication if H. pylori positive, then repeat faeces test and refer if still symptomatic.

Referral threshold – persistent dyspepsia with negative H. pylori test, despite proton pump inhibitor OR failed eradication therapy (tried once), proved by repeat stool antigen testing two weeks after eradication therapy

Gastro-oesophageal reflux disease (GORD)

Pre-referral treatment – twice daily proton pump inhibitor and alginate

Referral threshold – failed medical treatment

NICE guidance

Please see right for the NICE Quick Reference Guide on dyspepsia, published in 2004.

  • Referral criteria, pages 5-6
  • Management of dyspepsia not needing referral, page 8
  • Management of gastro-oesophageal reflux disease, page 9
  • Management of gastric ulcer, page 10
  • Management of duodenal ulcer, page 11
  • Management of non-ulcer dyspepsia, page 12
  • Helicobacter pylori testing and eradication, page 14
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Rugby & South Warwickshire Guidance  
Bar-None Health Care Services SWFT

Patients in Rugby can be referred to open access endoscopy in Warwick if they have symptoms that do not meet the upper GI 2 week criteria.

Refer via NHS E-referral to Bar-None Health Care Services.

Who Are We?

JAG accredited Endoscopy Unit, which consists of 3 endoscopy rooms and aims to provide 28 sessions per week.

Bar-None Healthcare have provided an open access endoscopy service for patients in South Warwickshire and neighbouring areas for many years.

Patients are referred directly by their GP, avoiding the need for an out-patient appointment beforehand. All of the endoscopies are carried out on the Endoscopy Unit at Warwick Hospital by experienced endoscopists, including GP endoscopists, a specialist nurse and consultants.

What do we do?

The endoscopy unit provides both in-patient and outpatient services for patients requiring endoscopic procedures, comprising:

  • Gastroscopy (Therapeutic and diagnostic)
  • Colonoscopy (Therapeutic and diagnostic)
  • Flexi-Sigmoidoscopy (Therapeutic and diagnostic)
  • Bronchoscopy
  • Cystoscopy (Therapeutic and diagnostic)
  • ERCP
  • PEG/JEG/NJ Tube
  • Urea Breath Tests
  • National Bowel Screening
  • Colonic Stent service including for UHCW










Where are we and our opening times?

The Endoscopy Unit is open 08:00 to 18:30 Monday to Friday, and the building is situated next to the disabled car park opposite the main hospital entrance.

The majority of patients using the service are seen on a day case basis. The unit also provides a service for adult patients admitted to the ward on a planned and unplanned basis. An On Call service is provided outside of routine hours by an on call medical or surgical endoscopist and endoscopy nurses via switchboard.

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