Dyspepsia refers to acute, chronic, or recurrent pain or discomfort centered in the upper abdomen. An international committee of clinical investigators (Rome III Committee) has defined dyspepsia as epigastric pain or burning, early satiety, or postprandial fullness. Heartburn (retrosternal burning) should be distinguished from dyspepsia. When heartburn is the dominant complaint, gastroesophageal reflux is nearly always present. Dyspepsia occurs in 15 % of the adult population and accounts for 3% of general medical office visits.
Food or Drug Intolerance
Luminal Gastrointestinal Tract Dysfunction
Helicobacter pylori Infection
Biliary Tract Disease
Clinical Findings and Treatment:
Epigastric pain or burning, early satiety, or postprandial fullness.
Endoscopy is warranted in patients with alarm features or in those older than 55 years.
All other patients should first undergo testing for Helicobacter pylori or a trial of empiric proton pump inhibitor.
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Talley NJ et al. Effect of amitriptyline and escitalopram on functional dyspepsia: a multicenter, randomized controlled study. Gastroenterology. 2015 Aug; 1 49(2):340-9.e2. [PMID:25921377]
Talley NJ et al. Functional dyspepsia. N Eng! J Med. 2015 Nov 5; 373(19):1853-63. [PMID:26535514]