Management and safety netting

Given the uncertainty with the diagnosis it is important, before formulating a treatment plan, that ALARM symptoms (Anaemia, Loss of weight, Anorexia, Recent onset of progressive symptoms, Malaena) are ruled out. If any of these are present, referral to a GP has to be made. A medication history should be sought as a number of medicines are known risk factors in developing ulcers, most notably NSAIDs, but also bisphosphonates, corticosteroids and SSRIs.

If these safety net-type questions are negativeit would seem reasonable to treat his GI pain with either an antacid or PPI. However, if symptoms persist or reoccur, a further assessment by the GP would be advisable.

In addition to pharmacological intervention, lifestyle advice could also be given.