Management of Drug-induced Dyspepsia in Children: Current Evidence and Clinical Approach
Abstract
UNLABELLED: Drug-induced dyspepsia (DID) represents an often overlooked cause of upper gastrointestinal (GI) discomfort in children, frequently mimicking functional dyspepsia or gastroesophageal reflux disease (GERD). This review synthesizes current evidence on the diagnosis and management of pediatric DID, integrating expert consensus and available clinical data. Accurate diagnosis of pediatric DID depends on a thorough medication history, covering prescription, over-the-counter (OTC), and supplement use, alongside symptom correlation with drug exposure. Standardized tools such as the EMPACIP Likert dyspepsia severity scale may improve diagnostic precision and enable symptom monitoring. A stepwise management approach involves identifying and discontinuing or substituting the offending agent, implementing dietary and lifestyle modifications, and initiating pharmacologic therapy when needed. H2-receptor antagonists (H2RAs) are recommended as the preferred therapy due to their rapid onset, safety profile, and suitability for on-demand use, while proton pump inhibitors (PPIs) are suggested to be reserved for refractory or severe cases with mucosal injury. Prokinetic agents may have a role in select cases with motility-related symptoms, though evidence remains limited. Long-term or prophylactic use of acid-suppressive medications should be approached cautiously, with regular reassessment and tapering to prevent unnecessary exposure. Significant knowledge gaps persist regarding…
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