DEFINITIONS OF DYSPEPSIA

The definition of the term dyspepsia and of derived terms such as organic dyspepsia, functional dyspepsia, reflux-like dyspepsia, and non-ulcer dyspepsia continues to provoke controversy. In recent literature, however, it is apparent that a measure of agreement is now emerging with regard to 'dyspepsia', which is considered simply to denote episodic or persistent symptoms that include abdominal pain or discomfort and which are referable to the upper gastrointestinal tract. Particular symptom patterns may justify the use of descriptions such as reflux-like dyspepsia, ulcer-like dyspepsia, or dysmotility-like dyspepsia, but these terms should not carry any implication that the symptom patterns can be attributed to particular pathogenetic processes. In many patients with dyspepsia, clinical assessment and investigation fail to identify any abnormality to which the symptoms can reasonably be attributed. The label of 'functional dyspepsia' is well-established medical parlance in these circumstances and is generally accepted as the converse of 'organic dyspepsia', which denotes dyspepsia for which a responsible disease process has been identified.