Dyspepsia is defined as epigastric pain lasting for at least 1 month that can be associated with epigastric fullness, nausea, vomiting, or heartburn. Dyspepsia can be caused by Helicobacter pylori infection, esophagitis, peptic ulcer disease, and gastroesophageal reflux disease (GERD) and can be worsened by medications, cigarette smoking, and alcohol. Functional dyspepsia is the term used for patients when endoscopy and other diagnostic tests have ruled out organic pathology.
The most common drugs that cause dyspepsia include aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), which can contribute to mucosal damage, ulceration, and bleeding complications. Other associated medications include iron, antibiotics, antihypertensives, narcotics, estrogens, theophylline, selective serotonin reuptake inhibitors (SSRIs), niacin, digoxin, corticosteroids, levodopa, and hypoglycemic agents. These medications can cause symptoms by causing direct gastric mucosal injury (eg, NSAIDs), a change in gastrointestinal sensorimotor function, worsening GERD, or idiopathic mechanisms.
Management of drug-induced dyspepsia includes drug discontinuation, assessment of underlying pathology, and symptom control.
Drug-induced dyspepsia
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Synopsis

Codes
ICD10CM:
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter
SNOMEDCT:
299969005 – Drug-induced dyspepsia
T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter
SNOMEDCT:
299969005 – Drug-induced dyspepsia
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Peptic ulcer disease
- Gastroesophageal reflux disease (GERD)
- Functional dyspepsia
- Esophagitis (drug-induced, candidal, reflux-related)
- H pylori infection
- Chronic pancreatitis
- Irritable bowel disease
- Crohn disease
- Celiac disease
- Gastric cancer
- Gastroparesis
- Menetrier disease
- Gastric amyloidosis
- Mesenteric ischemia
- Chronic gastric volvulus
- Cholelithiasis
- Choledocholithiasis
- Sphincter of Oddi dysfunction
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:01/03/2019
Last Updated:01/14/2019
Last Updated:01/14/2019