The value of alarm features in identifying organic causes of dyspepsia

713-720. The unaided clinical diagnosis of dyspepsia is of limited value in separating functional dyspepsia from clinically relevant organic causes of dyspepsia (gastric and esophageal malignancies, peptic ulcer disease and c omplicated esophagitis). The identification of one or more alarm features, such as weight loss, dysphagia, signs of gastrointestinal bleeding, an abdo minal mass or age over 45 years may help identify patients with a higher ri sk of organic disease. This review summarizes the frequency of alarm sympto ms in dyspeptic patients in different settings (such as the community, prim ary care and specialist clinics). The prevalence of alarm features in patie nts diagnosed with upper gastrointestinal malignancy or peptic ulcer diseas e is described. The probability of diagnosing clinically relevant upper gas trointestinal disease in patients presenting with alarm features and other risk factors is discussed. Alarm features such as age, significant weight l oss, use of nonsteroidal anti-inflammatory drugs, signs of bleeding and dys phagia may help stratify dyspeptic patients and help optimize the use of en doscopy resources.