[Nonulcer dyspepsia].

Nonulcer dyspepsia or chronic dyspepsia (defined as upper gastrointestinal symptoms of at least 3-weeks duration) is a common problem in Western countries. Up to 30% of the general population suffer from dyspepsia and the dyspepsia-related work-load of the general practitioner is considerable. The general practitioner has to formulate a management approach: what therapy, if any, and which patient should be investigated? A considerable overlap of symptoms make a precise diagnosis without additional investigations difficult, but empirical acid inhibition is an attractive option. Disturbances of gastrointestinal motility and, perhaps, Helicobacter gastritis are additional possible pathogenetic mechanisms. At present, conclusive, controlled clinical trials are lacking and it remains controversial which strategy is most cost-effective but at the same time optimal for the patient.