[Acid-related disorders].

The diagnostic value of dyspeptic symptoms, various management strategies for dyspepsia and possible long-term consequences of acid inhibition is reviewed. In functional dyspepsia a uniform response to drug treatment is not likely, and acid suppression is not superior to placebo. A random starting day trial design identifies true drug response in a minority of patients. A symptom-driven management approach will reduce long term drug intake in reflux patients. The proportion of H. pylori-negative ulcers has increased; helicobacter status must be assessed in all ulcer patients.