Older dyspeptic patients and those with ‘alarm’ symptoms or
signs require endoscopy to exclude upper GI cancer and make a diagnosis;
younger patients with simple dyspepsia are treated empirically with
a course of proton pump inhibitors (PPIs) or an H. pylori ‘test and
treat’ strategy. For H. pylori-associated ulcers, H. pylori treatment induces
healing and prevents relapse.