II. Precautions: Red Flags may suggest serious underlying conditions

III. Precautions: Red Flags in Dyspepsia

  1. Age of onset cut-off
    1. Current age cut-off: age over 60 years
    2. Recent literature suggests adjusting based on gender
      1. Age over 35 years in men
      2. Age over 56 years in women
      3. Marmo (2005) Am J Gastroenterol 100:784-91 [PubMed]
  2. Dysphagia
  3. Anorexia or early satiety
  4. Persistent Vomiting
  5. Jaundice
  6. Palpable abdominal mass or epigastric mass
  7. Supraclavicular Lymphadenopathy
  8. Family History of Gastric Cancer
    1. More common in non-caucasian (esp. black patients)
  9. Prior Peptic Ulcer Disease history
  10. Unexplained weight loss
    1. Weight loss more than 3 kg or 6.5 pounds
    2. Weight loss >10% of body weight
  11. Signs of significant Gastrointestinal Bleeding
    1. Anemia
    2. Rectal Bleeding or Melena

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