▁rule ▁out ▁pe ptic ▁ul cer ▁disease , ▁medic ation - related ▁ul cer ation , ▁m align ancy ▁and ▁other ▁r ar er ▁causes . ▁ ▁People ▁under ▁the ▁age ▁of ▁ 5 5 ▁years ▁with ▁no ▁alarm ▁features ▁do ▁not ▁need ▁end os copy ▁but ▁are ▁considered ▁for ▁investigation ▁for ▁pe ptic ▁ul cer ▁disease ▁caused ▁by ▁Hel ic ob acter ▁p yl ori ▁in fection . ▁Investig ation ▁for ▁H . ▁p yl ori ▁in fection ▁is ▁usually ▁performed ▁when ▁there ▁is ▁a ▁moder ate ▁to ▁high ▁pre val ence ▁of ▁this ▁in fection ▁in ▁the ▁local ▁community ▁or ▁the ▁person ▁with ▁d ys pe ps ia ▁has ▁other ▁risk ▁factors ▁for ▁H . ▁p yl ori ▁in fection , ▁related ▁for ▁example ▁to ▁eth nic ity ▁or ▁imm igration ▁from ▁a ▁high - pre val ence ▁area . ▁If ▁in fection ▁is ▁confirmed , ▁it ▁can ▁usually ▁be ▁er adic ated ▁by ▁medic ation . ▁ ▁Medic ation - related ▁d ys pe ps ia ▁is ▁usually ▁related ▁to ▁NS A ID s ▁and ▁can ▁be ▁complicated ▁by ▁ble eding ▁or ▁ul cer ation ▁with ▁per for ation ▁of ▁st om ach ▁wall . ▁ ▁Tre at ment ▁ ▁Function al ▁and ▁und iffer enti ated ▁d ys pe ps ia ▁have ▁similar ▁treat ments . ▁D rug ▁ther apy ▁dec isions ▁are ▁difficult ▁because ▁tri als ▁included ▁heart burn ▁in ▁the ▁definition ▁of ▁d ys pe ps ia . ▁This ▁led ▁to ▁the ▁results ▁favor ing ▁pro ton