[Physiopathological approach to non-ulcerative dyspepsia: clinical consequences]

Non-ulcer like dyspepsia comprises different symptoms of the upper intestinal tract with no macroscopic lesion and no identifiable etiology. Motility disturbances are the best known alterations and resemble a delay in the emptying of the stomach. Gastroesophageal reflux may produce atypical symptoms. Mucosal lesions are sometimes found which may explain the transmucosal electric potential differences. However, chronic active Helicobacter associated gastritis is usually asymptomatic. There has been no proof of psychological factors up to now. In 50% of the patients the minimum pain threshold in response to distention of the stomach is lowered. No generally accepted therapy has been found. The therapeutic principles depend on the pathogenesis of the syndrome in every individual. Medication which may enhance as well as inhibit motility may be of help.