| [ Summary ] |
Dyspepsia is a common symptom for which an organic cause is found in about 50% of patients. When no cause is apparent and the dyspepsia is considered to be a diagnosed non-ulcer dyspepsia (NUD) is made. The pathophysiology of NUD is poorly understood and numerous theories have been put forward. NUD is a problem that is difficult to treat in clinical practice. Although up to 50% of patients diagnosed with NUD have H. pylori infection and underlying chronic gastritis, these remains some controversy as to whether any causative relationship exists. The results of world wide epidemiological studies have been unconvincing. No clear cut link has been documented between H. pylori and any specific symptom profile or pathophysiological mechanism of NUD. However, eradication of H. pylori infection may be beneficical in a small subgroup of cases with NUD that cannot be identified before treatment. The placebo effect on the symptoms of NUD and on quality of life was marked. Prokinetic agents and acid inhibition with H2 blockers have shown variable efficacy in the treatment of NUD. Guidelines for the management of dyspepsia and NUD are reviewed. |