[Dyspepsia: work-up or provisional treatment?]

Dyspepsia is defined as symptoms that are considered by a physician to originate from the upper gastrointestinal tract. The term 'functional dyspepsia' designates dyspepsia after exclusion of organic causes. Dyspepsia is a frequent problem in general practice. Mainly for economical reasons, it is impossible to perform every available diagnostic test in every patient to exclude all possible organic causes. The initial work-up is directed at identifying alarm symptoms and alarm signs from history, physical examination, and simple laboratory tests. The presence of any alarm symptoms or alarm sign requires prompt investigation. If none can be found, empirical drug treatment may be performed according to the leading symptom. Treatment failure or rapid recurrence require additional investigations, in particular by gastroscopy.