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What is behind dyspepsia?

A G Klauser1, W A Voderholzer, P A Knesewitsch

  • 1Department of Gastroenterology, Klinikum Innenstadt, Medizinische Klinik University of Munich, Germany.

Digestive Diseases and Sciences
|January 1, 1993
PubMed
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For persistent dyspepsia, extended diagnostic work-up identified causes in 47% of patients after initial negative tests. Symptom clusters were unreliable predictors of specific gastrointestinal diseases.

Area of Science:

  • Gastroenterology
  • Diagnostic Medicine

Background:

  • Dyspepsia affects many patients, often without a clear cause after initial investigations.
  • Conventional diagnostic work-ups do not always identify the etiology of dyspepsia.

Purpose of the Study:

  • To determine the cause of dyspepsia in patients with negative conventional diagnostic work-ups.
  • To evaluate the predictive value of symptom clusters for specific gastrointestinal diseases.

Main Methods:

  • Extended diagnostic work-up including esophageal pH monitoring, manometry, scintigraphy, and lactose tolerance tests.
  • Analysis of symptom clusters (gastroesophageal reflux-like, dysmotility-like) in relation to diagnoses.

Main Results:

  • Conventional work-up diagnosed 40% of dyspeptic patients.

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  • Extended work-up identified causes in 47% of remaining patients, including endoscopy-negative gastroesophageal reflux disease, gastric stasis, biliary dyskinesia, and lactase deficiency.
  • Symptom clusters did not reliably predict underlying diagnoses.

    • Conclusions:

    • Extended functional testing is valuable for diagnosing unexplained dyspepsia.
    • Symptomatology alone is insufficient for predicting specific diagnoses in these patients.