From the Guidelines
Red flags of dyspepsia that require immediate medical attention include severe abdominal pain, vomiting blood or material that looks like coffee grounds, black or bloody stools, unintended weight loss, difficulty swallowing, and indigestion that persists for more than two weeks despite using over-the-counter medications, as these symptoms may indicate serious conditions such as gastrointestinal bleeding, ulcers, or cancer. According to the British Society of Gastroenterology guidelines on the management of functional dyspepsia 1, dyspepsia is diagnosed in the absence of a structural abnormality to explain the symptoms, and symptoms alone are not reliable in distinguishing functional from organic causes of dyspepsia.
The guidelines also recommend urgent endoscopy only in patients aged ≥55 years with dyspepsia with evidence of weight loss, and non-urgent endoscopy can be considered in patients aged ≥55 years with treatment-resistant dyspepsia or dyspepsia with either a raised platelet count or nausea or vomiting 1. Other concerning signs include persistent vomiting, severe abdominal pain, and difficulty swallowing. Yellowing of the skin or eyes (jaundice) and a feeling of fullness or bloating that doesn't go away are also concerning symptoms.
Key red flags to look out for include:
- Severe abdominal pain
- Vomiting blood or material that looks like coffee grounds
- Black or bloody stools
- Unintended weight loss
- Difficulty swallowing
- Indigestion that persists for more than two weeks despite using over-the-counter medications
- Yellowing of the skin or eyes (jaundice)
- A feeling of fullness or bloating that doesn't go away
These symptoms warrant prompt medical evaluation because they may indicate serious conditions such as gastrointestinal bleeding, ulcers, gallbladder disease, or even cancer. While occasional indigestion is common and can be managed with lifestyle changes and over-the-counter medications like antacids, persistent or severe symptoms should never be ignored as they could represent more serious underlying conditions requiring specific treatment 1.
From the Research
Red Flags of Dyspepsia
The red flags of dyspepsia, also known as indigestion, are indicators that may suggest a more serious underlying condition. Some of these red flags include:
- Unintended weight loss 2
- Progressive dysphagia (difficulty swallowing) 2, 3
- Persistent vomiting 2
- Evidence of gastrointestinal bleeding 2
- A family history of cancer 2
- Dysphagia (difficulty swallowing) 3
- Weight loss 3
- Bleeding 3
Warning Signs of Serious Disease
Warning signs of serious disease, such as cancer, may include:
- Unexplained weight loss 2, 3
- Progressive difficulty swallowing 2, 3
- Vomiting blood or black tarry stools 2
- Abdominal pain that worsens over time 4
- A family history of gastrointestinal cancer 2
Diagnostic Evaluation
Diagnostic evaluation of dyspepsia may include: