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Finally, given that traditional and sociocultural influence may play a role in herbal medicine use during pregnancy, there is a need to better understand the reasons and facilitators of herbal medicine use in pregnant women from sub-Saharan Africa

Dyspepsia in the community Older patients presenting for the first time and those with alarm symptoms or signs (weight loss, dysphagia, persistent vomiting, gastrointestinal bleeding, unexplained anemia, epigastric mass, previous gastric ulcer or gastric surgery) should be referred for upper gastrointestinal endoscopy and /or other investigations, both to exclude malignancy and to make a positive diagnosis