H. pylori infection can be diagnosed from an endoscopic biopsy and soon through a breath hydrogen assay. However, caution is required in using this diagnosis or any other nonspecific findings to explain the symptoms. Esophageal manometry is indicated only if dysphagia, regurgitation, or evidence of aspiration suggests an esophageal motor disorder. Differential Diagnosis Functional dyspepsia is generally a benign condition, which, by definition, has no pathologic correlation. Psychologic causes include anxiety with or without aerophagia, conversion disorder, somatization in depression, or hypochondriasis.
Cholelithiasis is unlikely to cause dyspepsia without other clinical findings.
Thus, if abdominal ultrasound reveals gallstones in a functioning gallbladder, cholecystectomy may not relieve the dyspepsia. Treatment Functional dyspepsia usually calls first for reassurance and symptomatic treatment with observation over time. Treatment of reflux symptoms or epigastric discomfort may be tried for brief periods with antacids, H 2 blockers, or proton pump inhibitors. If H. pylori is diagnosed, treatment with bismuth subsalicylate and an antibiotic regimen should be tried. All rights reserved.