Skip to main content
SpringerLink
Log in

Clinical Approach to Non-Ulcer Dyspepsia

  • Chapter
Gastrointestinal Motility

  • 129 Accesses

Abstract

The first modern description of dyspepsia (1), described it as an “episodic or persistent” abdominal pain in the absence of bleeding or jaundice. Since then, various descriptions have been used (2, 3). These definitions include symptoms of peptic ulcer disease in a subject without an ulcer (2) and upper abdominal pain with a lack of identifiable cause (3). In 1989, Barbara, et al. once again tried to define NUD (dyspepsia) as episodic or persistent abdominal symptoms often related to feeding, which patients or physicians believe to be due to disorders of the proximal portion of the digestive tract (4). More recently, groups have tried to sub-categorize NUD into categories such as reflux-like, dysmotilitylike, ulcer-like (5,6) and even irritable bowel-like (7).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Crean GP, Land WI, Beattie AD, et al. Ulcer-like dyspepsia. Scand J Gastroenterol 1982;17(Suppl 79):9–15.

    Google Scholar 

  2. Thompson WE. Non-ulcer dyspepsia. Can Med Assoc J 1984;13:565–9.

    Google Scholar 

  3. Lagarde SP, Spiro HM. Non-ulcer dyspepsia. Clin Gastroenterol 1984;13:437–46.

    PubMed  CAS  Google Scholar 

  4. Barbara L, Camilleri M, Corinaldesi R, et al. Definition and investigation of dyspepsia: Consensus of an ad hoc working party. Dig Dis Sci 1989;34:1272–76.

    Article  PubMed  CAS  Google Scholar 

  5. Colin-Jones DG. Management of dyspepsia: report of a working party. Lancet 1988;1:576–9.

    Google Scholar 

  6. Colin-Jones DG. Dyspepsia Update. Scand J Gastroenterol 1995;30 (Suppl 210);32–5.

    Article  Google Scholar 

  7. Talley NJ, Zinsmeister AR, Schleck CD, Melton U. Dyspepsia and dyspepsia subgroups: A population-based study. Gastro 1992:102;1259–68.

    CAS  Google Scholar 

  8. Sahay P, Axon AT. Non-ulcer dyspepsia: Does Helicobacter matter. Postgrad Med J 1995;71:262–4.

    Article  PubMed  CAS  Google Scholar 

  9. Buckley M, O’Morain C. Prevalence of Helicobacter pylori in non-ulcer dyspepsia. Aliment Pharm Ther 1995;9:53–8.

    Google Scholar 

  10. Porro CG, Parente F. Nature of non-ulcer dyspepsia and related conditions. Baillieres Clin Gastro 1995;9:549–62.

    Article  Google Scholar 

  11. Talley NJ. Modern management of dyspepsia. Aust Fam Phys 1996;25:47–52.

    CAS  Google Scholar 

  12. O’Morain C, Buckley M. Helicobacter pylori and dyspepsia. Scand J Gastroenterol 1996;Suppl 214:28–30.

    Article  Google Scholar 

  13. Armstrong D. Helicobacter pylori infection and dyspepsia. Scand J Gastroenterol 1996;Suppl 215:38–47.

    Article  CAS  Google Scholar 

  14. Talley NJ. Helicobacter pylori and non-ulcer dyspepsia. Scand J Gastroenterol 1996;Suppl 220:19–22.

    Article  CAS  Google Scholar 

  15. Laheji RJ, Jansen JB, van de Lisdonk E, et al. Review article: Symptom improvement through eradication of Helicobacter pylori in patients with non-ulcer dyspepsia. Aliment Pharm Ther 1996;10:843–50.

    Article  Google Scholar 

  16. Veldhuyzen van Zanten SJ. The role of Helicobacter pylori infection in non-ulcer dyspepsia. Aliment Pharm Ther 1997;11(Suppl 1):63–9.

    Article  Google Scholar 

  17. Bobrzynski A. Hormonal, secretory and morphological alterations in gastric mucosa in the course of Helicobacter pylori eradication in patients with duodenal ulcer and non-ulcer dypepsia. J Physiol Pharm 1997;48(Suppl 3):1–56.

    Google Scholar 

  18. Froelich F, Gonvers JJ, Beglinger C. Has the time now arrived to eradicate Helicobacter pylori routinely in non-ulcer dyspepsia. Eur J Gastro Hep 1997;9:917.

    Article  Google Scholar 

  19. de Boer WA. Helicobacter pylori and non-ulcer dyspepsia. Scand J Gastroenterol 1997;32:535–40.

    Article  Google Scholar 

  20. Agreus L, Talley NJ. Dyspepsia: Current understanding and management. Ann Rev Med 1998;49:475–93.

    Article  PubMed  CAS  Google Scholar 

  21. Thompson WG, Dotevall G, Drossman DA, et al. Irritable bowel syndrome: guidelines for the diagnosis. Gastroenterol Int 1989;2:92–95.

    Google Scholar 

  22. Drossman DA, Thompson WG, Talley NJ, et al. Identification of sub-groups of functional gastrointestinal disorders. Gastroenterol Int 1990;3:159–72.

    Google Scholar 

  23. Sandler RS. Epidemiology of irritable bowel syndrome in the US. Gastro 1990:99:409--15.

    CAS  Google Scholar 

  24. Thompson WG, Heaton KW. Functional bowel disorders in apparently healthy people. Gastro 1980:79:283–8.

    CAS  Google Scholar 

  25. Talley NJ, Weaver AL, Zinsmeister AR, et al. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol 1992;136:165–77.

    PubMed  CAS  Google Scholar 

  26. Talley NJ, Colin-Jones D, Koch KJ, et al. Functional dyspepsia: a classification with guidelines for diagnoses and management. Gastroenterol Int 1991;4:145–60.

    Google Scholar 

  27. Malagelada JR, Stanghellini V. Manometric evaluation of functional upper gut symptoms. Gastro 1985;88:1223–31.

    CAS  Google Scholar 

  28. Rees WDW, Miller LJ, Malagelada JR. Dyspepsia, antral motor dysfunction, and gastric stasis of solids. Gastro 1980;78:360–65.

    CAS  Google Scholar 

  29. Kerlin P. Postprandial antral hypomotility in patients with idiopathic nausea and vomiting. Gut 1989;30:54–9.

    Article  PubMed  CAS  Google Scholar 

  30. Scott AM, Kellow JE, Shutcr B, et al. Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia. Dig Dis Sci 1993;12:2247–54

    Article  Google Scholar 

  31. Chang CS, Chen GH, Kao CH, et al. Gastric clearance of radiopaque markers in non-ulcer dyspepsia patients. Scand J Gastroenterol 1996;31:136–9.

    Article  PubMed  CAS  Google Scholar 

  32. Mittal BR, Dhiman RK, Maini A, et al. Gastric emptying in patients with non ulcer dyspepsia (dysmotility type). Trop Gastroenterol 1997;18:67–9.

    PubMed  CAS  Google Scholar 

  33. Lopez GA, Lopez DGA, Samiento A, Andrusch A. Abnormalities in gastric mechanic sensitivity, gastric emptying and electrogastrography in non organic dyspepsia (NOD). Acta Gastro Latinoamer 1997;27:7.

    Google Scholar 

  34. Cucchiara S, Riezzo G, Minella R, et al. Electrogastrography in non-ulcer dyspepsia. Arch Dis Child 1992;67:613.

    Article  PubMed  CAS  Google Scholar 

  35. Pfaffenbach B, Adamek RJ, Barthotomaus C, Wegener M. Gastric dysrhythmias and delayed gastric emptying in patients with functional dyspepsia. Dig Dis Sciences 1997;42:2094.

    Google Scholar 

  36. Parkman HP, Miller MA, Trate D, et al. Electrogastrography and gastric emptying scintigraphy arc complementary for assessment of dyspepsia. J Clin Gastro 1997;24:214.

    Article  CAS  Google Scholar 

  37. Thor P, Lorens K, Tabor S, et al. Dysfunction in gastric myoelectrical and motor activity in Helicobacter pylori positive gastritis patients with non-ulcer dyspepsia. J Physiol Pharm 1996;47:469.

    CAS  Google Scholar 

  38. Geldof H, van der Schee EJ, Smout AJPM, et al. Myoelectrical activity of the stomach in gastric ulcer patients: An eleetrogastrographic study. J Gastro Motility 1989;1:122.

    Article  Google Scholar 

  39. Nabar AA, Bhatia SJ, Abraham P, et al. Total and segmental colonic transit time in non ulcer dypepsia. Ind J Gastro 1995;12:131–3.

    Google Scholar 

  40. Pfeiffer A, Aronbayev J, Schmidt T, et al. Gastric emptying, esophageal 24-hour pH and gastric potential difference measurements in non-ulcer dyspepsia. Gastroenterol Clin Biol 1992;16:395–400.

    PubMed  CAS  Google Scholar 

  41. Klauser AG, Voderholzer WA, Knesewitsch PA, et al. What is behind dyspepsia? Dig Dis Sci 1993;38:147–54.

    Article  PubMed  CAS  Google Scholar 

  42. Gotthard R, Bodemar G. Brodin U, et al. Treatment with cimetidine, antacid, or placebo in patients with dyspepsia of unknown origin. Scand J Gastroenterol 1988;23:7–18.

    Article  PubMed  CAS  Google Scholar 

  43. Johannessen T, Fjosne U, Kleveland PM, et al. Cimetidine responders in non-ulcer dyspepsia. Scand J Gastroenterol 1988;23:327–36.

    Article  PubMed  CAS  Google Scholar 

  44. Farup PG, Larsen S, Ulshagen K, et al. Ranitidine for non-ulcer dyspepsia. A clinical study of the symptomatic effect of ranitidine and a classification and characterization of the responders to treatment. Scand J Gastroenterol 1991;26:1209–16.

    Article  PubMed  CAS  Google Scholar 

  45. Johannessen T, Petersen H, Kristensen P, et al. Cimetidine on-demand in dyspepsia. Experience with randomized controlled single-subject trials. Scand J Gastroenterol 1992;27:189–95.

    Article  PubMed  CAS  Google Scholar 

  46. Jamieson JR, Stein HJ, DeMeester TR, et al. Ambulatory 24-H Esophageal pH monitoring: Normal values, optimal threshold, specificity, sensitivity, and reproducibility. Am J Gastro 1992;87:1102–11.

    CAS  Google Scholar 

  47. Heading RC. Epidemiology of oesophageal reflux disease. Scand J Gastroenterol 1989;24(suppl 168):33–7.

    Google Scholar 

  48. Schindlbeck NE, Klauser AG, Berghammer G, et al. Three year follow up of patients with gastrooesophageal reflux disease. Gut 1992;33:1016–9.

    Article  PubMed  CAS  Google Scholar 

  49. Klauser AG, Voderholzer WA, Knesewitsch PA. Et al. What is behind dyspepsia? Dig Dis Sci 1993;38:147–54.

    Article  PubMed  CAS  Google Scholar 

  50. Schindlbeck NE Wiebecke B, Klauser AG, et al. Diagnostic value of histology in non-erosive reflux disease. Gut 1996;39:151–4.

    Article  Google Scholar 

  51. Hewson EG, Sinclair JW, Dalton CB, et al. Twenty-four hour esophageal pH monitoring. The most useful test for evaluating noncardiac chest pain. Am J med 1991;90:576–83.

    PubMed  CAS  Google Scholar 

  52. Janssen J, Vantrappen G, Ghillibert G. 24-hour recording of esophageal pressure and pH in patients with noncardiac chest pain. Gastro 1986;90:1978–84.

    Google Scholar 

  53. Decaestecker JS. Blackwell JN, Brown J et al. The oesophagus as a cause of recurrent chest pain:-which patients should be investigated and which tests should be used? Lancet 1985;2:1143–46.

    Google Scholar 

  54. Fass R, Fennerty B, Ofman JJ, et al. The clinical and economic value of a short course of omeprazole in patients with noncardiac chest pain. Gastro 1998;115:42–9.

    Article  CAS  Google Scholar 

  55. Achem SR, Kolts BE, MacMath T, et al. Effects of omeprazole versus placebo in treatment of noncardiac chest pain and gastroesophageal reflux. Dig Dis Sci 1997;42:2138–45.

    Article  PubMed  CAS  Google Scholar 

  56. Mearin F, Cucala M, Azpiroz F, et al. The origin of symptoms on the brain-gut axis in functional dyspepsia. Gastro 1991;101:999–1006.

    CAS  Google Scholar 

  57. Lemann M, Dederding JP, Flourie B, et al. Abnormal perception of visceral pain in response to gastric distension in chronic idiopathic dyspepsia. Dig Dis Sci 1991;36:1249–54.

    Article  PubMed  CAS  Google Scholar 

  58. Bradette M, Pare P, Douville P, et al. Visceral perception in health and functional dyspepsia. Dig Dis Sci 1991;36:52–58.

    Article  PubMed  CAS  Google Scholar 

  59. Coffin B, Azpiroz F, Guamer Et al. Selective gastric hypersensitivity and reflex hyporeactivity in functional dyspepsia. Gastro 1994;107:1345–51.

    CAS  Google Scholar 

  60. Barbera R, Feinle C, Read NW. Nutrient-specific modulation of gastric mechanosensitivity in patients with functional dyspepsia. Dig Dis Sci 1995;40:1636–41.

    Article  PubMed  CAS  Google Scholar 

  61. Fraitag B, Homerin M, Hecketsweiler P. Double-blind dose-response multicenter comparison of fedotozine and placebo in treatment of nonulcer dyspepsia. Dig Dis Sci 1994;39:1072–77.

    Article  PubMed  CAS  Google Scholar 

  62. Dapoigny M, Abitbol JL, Fraitag B. Efficacy of peripheral kappa agonist fedotozine versus placebo in treatment of irritable bowel syndrome: A multicenter dose response study. Dig Dis Sci 1995;40:2244--48.

    Article  CAS  Google Scholar 

  63. Read NW, Abitbol JL, Bardhan KD, et al. Efficacy and safety of the peripheral kappa agonist fedotozine versus placebo in the treatment of functional dyspepsia. Gut 1997;41:664–8.

    Article  PubMed  CAS  Google Scholar 

  64. Talley NJ. A critique of therapeutic trials in Helicobacter pylori-positive functional dyspepsia. Gastro 1994;106:1174–83.

    CAS  Google Scholar 

  65. Silverstein MD, Petterson T, Talley NJ. Initial endoscopy or empirical therapy with or without testing for Helicobacter pylori for dyspepsia: a decision analysis. Gastro 1996;110:72–83.

    Article  CAS  Google Scholar 

  66. McNulty CAM, Gearty JC, Crump B, et al. Campylobacter pyloridisand associated gastritis: Investigator blind placebo-controlled trial of bismuth salicylate and erythromycin ethyl-succinate. BMJ 1986;293:645–9.

    Article  PubMed  CAS  Google Scholar 

  67. Lambert JR, Dunn K, Borromeo M, Korman MG, et al. Campylobacter pylori-arole in non-ulcer dyspepsia? Scand J Gastroenterol 1989;24(Suppl 160):7–13.

    Article  Google Scholar 

  68. Loffeld RJLF, Potters HVJP, Toberingh E, et al. Campylobacter associated gastritis in patients with non-ulcer dyspepsia: A double blind placebo controlled trial with colloidal bismuth subcitrate. Gut 1989;30:1206–12.

    Article  PubMed  CAS  Google Scholar 

  69. Frazzoni M, Lonardo A, Grisendi A, et al. Are routine duodenal and antral biopsies useful in the management of “functional” dyspepsia? A diagnostic and therapeutic study. J Clin Gastroenterol 1993;17:101–8.

    Article  PubMed  CAS  Google Scholar 

  70. Farup PG, Hovde O, Breder O. Are frequent short gastro-oesophageal reflux episodes the cause of symptoms in patients with non-ulcer dyspepsia responding to treatment with ranitidine. Scand J Gastro 1995;30:829–32.

    Article  CAS  Google Scholar 

  71. Urbain JC, Siegel JA, Debie NC, Pauwels SP. Effect of cisapride on gastric emptying in dyspeptic patients. Dig Dis Sci 1988;33:779–83.

    Article  PubMed  CAS  Google Scholar 

  72. Cutts TF, Abel TL, Karas JG, Kuns J. Symptom improvement from prokinetic therapy corresponds to improved quality of life in patients with severe dyspepsia. Dig Dis Sci 1996;41:1369–78.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. GI Motility Program Department of Medicine, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California, 90048, USA

    Mark Pimentel & Henry C. Lin

Authors
  1. Mark Pimentel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henry C. Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Iowa College of Medicine, Iowa City, Iowa, USA

    Satish S. C. Rao

  2. Mayo Clinic, Rochester, Minnesota, USA

    Joseph A. Murray

  3. University of Iowa College of Medicine, Iowa City, Iowa, USA

    Jeffrey L. Conklin , Frederick C. Johlin , Konrad S. Schulze-Delrieu  & Robert W. Summers , ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Pimentel, M., Lin, H.C. (1999). Clinical Approach to Non-Ulcer Dyspepsia. In: Rao, S.S.C., Conklin, J.L., Johlin, F.C., Murray, J.A., Schulze-Delrieu, K.S., Summers, R.W. (eds) Gastrointestinal Motility. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4803-4_28

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-4803-4_28

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7176-2

  • Online ISBN: 978-1-4615-4803-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation