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Dyspepsia Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Dyspepsia. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you had dyspepsia?

    Why: to determine if acute or chronic. Chronic dyspepsia is defined as occurring for more than 3 months.

  2. What exactly do you mean by dyspepsia and how would you describe the discomfort? Dyspepsia or indigestion is a difficult, sometimes vague, symptom to define or evaluate. Dyspepsia is a discomfort related to eating which may include one or more of the following symptoms during or after the ingestion of food :- nausea, heartburn, regurgitation, upper abdominal discomfort, lower chest discomfort, acidity, sensation of fullness or unease in the upper abdomen, abdominal distention or excess wind e.g. A burning pain may suggest gastro-esophageal reflux; constricting pain may suggest angina, heart attack or esophageal spasm; deep gnawing pain may suggest peptic ulcer
  3. Can you point to exactly where the discomfort is and where it radiates to?

    Why: can help with diagnosis e.g. discomfort between the shoulder blades may suggest esophageal spasm, gall bladder disease or a duodenal ulcer; discomfort behind the sternum (breastbone) may suggest esophageal disorders or angina; discomfort in epigastrium (midline just below ribs) may suggest disorders of the biliary system, stomach or duodenum.

  4. Is there anything that makes the discomfort worse?

    Why: e.g. eating food may aggravate a gastric ulcer; eating fried or fatty foods will aggravate biliary disease, esophageal disorders and functional dyspepsia ( dyspepsia when no specific cause can be demonstrated); bending over will aggravate gastro-esophageal reflux; alcohol will aggravate gastro-esophageal reflux, oesophagitis, gastritis, peptic ulcer and pancreatitis.

  5. Is there anything you have found that makes the discomfort better?

    Why: e.g. eating food may relive a duodenal ulcer.

  6. What effect do food, milk and antacids have?

    Why: if discomfort is relieved by food and antacids may suggest duodenal ulcer, hiatus hernia and oesophagitis. If discomfort is brought on by food may suggest cholecystitis, gastric ulcer or reactions to toxins in food such as MSG or sulfites.

  7. What effect do coffee, onions and garlic have?
  8. What effect does a big meal have?
  9. What effect does drinking alcohol have?
  10. What effect does exercise have?

    Why: may suggest angina as cause of discomfort if brought on by exertion.

  11. Do fried or fatty foods make it worse?
  12. Do hot spicy foods effect it?
  13. Does the problem come on at night soon after you go to bed?
  14. Does it wake you at night?
  15. Does bending over

    Why: e.g. gardening make it worse?

  16. Are you under a lot of stress or have a lot of worry?

    Why: may aggravate indigestion due to affecting motility.

  17. Do you rush your meals?

    Why: may aggravate indigestion.

  18. Do you chew your food properly?- if not, may aggravate indigestion
  19. Are you pregnant?

    Why: pregnancy increases the risk of indigestion due to a relaxation of the lower esophageal sphincter.

  20. Past medical history?

    Why: e.g. scleroderma (rare but important cause of oesophagitis), irritable bowel syndrome, gallstones, chronic pancreatitis, achalasia, hiatus hernia, pernicious anemia (may increase the risk of stomach cancer).

  21. Medications?

    Why: e.g. non-steroidal anti-inflammatory medications (2-4 times the risk of gastric ulcers), anticholinergics, aspirin, calcium channel blockers, corticosteroids, digitalis, lipid lowering medications, narcotics, slow release potassium supplements, theophylline, tricyclic antidepressants and tetracycline - may all cause indigestion.

  22. Nicotine smoking?

    Why: cigarette smoking is an important cause of indigestion.

  23. Alcohol history?

    Why: alcohol is an important cause of dyspepsia both in the occasional drinker, especially red wine, with a large evening meal and in the problem drinker with alcoholic gastritis.

  24. Family history?

    Why: e.g. peptic ulcers.

  25. Acid regurgitation?

    Why: may suggest gastro-esophageal reflux, or oesophagitis.

  26. Waterbrash (excess secretion of saliva into the mouth)?

    Why: may suggest gastro-esophageal reflux, hiatus hernia or peptic ulcer.

  27. Pain on swallowing?

    Why: may suggest oesophagitis (especially if with hot and cold fluids) or stomach cancer.

  28. Cough or wheeze at night? -may suggest gastro-esophageal reflux
  29. Symptoms of angina or heart attack?

    Why: e.g. a common mistake is to attribute the discomfort of angina or a heart attack to a disorder of the gastro-intestinal tract. Must consider heartburn symptoms to be ischemic heart disease until proved otherwise.

  30. Recent weight loss?

    Why: may suggest stomach cancer, intestinal or mesenteric ischemia, pernicious anemia, chronic pancreatitis, chronic gastritis. Should also consider renal failure, cirrhosis of the liver and congestive heart failure.

  31. Symptoms of heartburn?

    Why: e.g. burning discomfort behind the sternum (breastbone) that radiates to the throat, associated with acid reflux, aggravated by heavy meals, swallowing hot and cold fluids, stooping, lying flat and lifting and straining, more likely to occur at rest than with exertion. Heartburn may be due to gastro-esophageal reflux, oesophagitis, hiatus hernia, peptic ulcer, scleroderma, pregnancy, obesity, smoking and alcohol, caffeine and some medications.

  32. Symptoms of peptic ulcer?

    Why: e.g. intermittent symptoms of gnawing or burning-type pain in the epigastrium (midline, under the ribs) which can be located by finger point, pain is worse before meals and relieved by taking antacids or food. Pain may waken the person at night.

  33. Symptoms of chronic pancreatitis?

    Why: e.g. deep boring upper abdominal pain, often radiating through to the back, fatty stools that float in toilet and are difficult to flush, possibly symptoms of diabetes.

  34. Symptoms of gallstones?

    Why: e.g. sudden onset of severe constant epigastric pain which may pass into the back. Symptoms are induced by a fatty meal.

  35. Symptoms of anemia?

    Why: e.g. tiredness, dizziness, muscle weakness, headache, shortness of breath on exertion - may suggest chronic oesophagitis, chronic gastritis, peptic ulcer or stomach cancer.

  36. Symptoms of irritable bowel syndrome?

    Why: e.g. alternating diarrhea and constipation, pellet-like stools, abdominal bloating, flatulence, belching.

  37. Diarrhea 30 minutes after a meal?

    Why: may suggest mesenteric ischemia.

Conditions listing medical symptoms: Dyspepsia:

The following list of conditions have 'Dyspepsia' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Dyspepsia or choose View All.

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