Final answer:
For a 60-year-old patient with dyspepsia and no GERD or NSAID use, evaluation for underlying causes, including testing for H. pylori or endoscopy, would be the next step, along with lifestyle and dietary changes to manage symptoms.
Step-by-step explanation:
The next step for a 60-year-old patient with dyspepsia without GERD (Gastroesophageal Reflux Disease) or NSAID (nonsteroidal anti-inflammatory drugs) use is to conduct an evaluation for potential underlying causes. Dyspepsia can be symptomatic of various gastrointestinal disorders, including peptic ulcers or presence of H. pylori infection. Investigations may include noninvasive testing for H. pylori or potentially an endoscopy if peptic ulcer disease or other gastrointestinal pathology is suspected. Moreover, lifestyle modifications and dietary adjustments can help manage dyspepsia symptoms. These might include eating smaller, more frequent meals, avoiding certain foods and medications that might irritate the stomach lining, and using antacids or acid-reducing medications as needed.