Digestive Diseases and Sciences

, Volume 38, Issue 1, pp 147–154 | Cite as

What is behind dyspepsia?

  • Andreas G. Klauser
  • Winfried A. Voderholzer
  • Peter A. Knesewitsch
  • Norbert E. Schindlbeck
  • Stefan A. Müller-Lissner
Original Articles


The first aim of the present study was to determine the cause of dyspepsia after negative conventional diagnostic work-up. In such patients, an extended diagnostic work-up was performed including esophageal pH monitoring and manometry, gastric and hepatobiliary scintigraphy, and lactose tolerance test. In 88 of 220 dyspeptic patients (mean age 49 years, range 17–87; 114 women) presenting to our gastroenterological outpatient department, a cause for dyspepsia was found by conventional work-up. Thirty-one of the remaining patients did not enter extended work-up, because of minor symptoms. In 47 of 101 patients entering extended work-up, a diagnosis was established (21 endoscopynegative gastroesophageal reflux disease, 11 gastric stasis, 6 biliary dyskinesia, and 5 lactase deficiency among them). A second aim of the study was to determine whether clusters of symptoms such as “gastroesophageal reflux-like”, “dysmotility-like”, and “dyspepsia of unknown origin” reliably predict the groups of diseases suggested by these terms. This was not the case. In conclusion, in 40% of dyspeptic patients, a conventional diagnostic work-up led to a diagnosis that explained a patient's symptoms. After a negative conventional diagnostic work-up, an extended diagnostic work-up with functional tests yielded a possible explanation for their symptoms in 47% of patients. In such patients symptomatology was of little help for predicting the diagnosis.

Key Words

dyspepsia diagnosis extended work-up symptomatology discriminant analysis 


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Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Andreas G. Klauser
    • 1
    • 2
  • Winfried A. Voderholzer
    • 1
    • 2
  • Peter A. Knesewitsch
    • 1
    • 2
  • Norbert E. Schindlbeck
    • 1
    • 2
  • Stefan A. Müller-Lissner
    • 1
    • 2
  1. 1.Department of Gastroenterology, Klinikum Innenstadt, Medizinische KlinikUniversity of MunichMunich 2Germany
  2. 2.Department of Nuclear Medicine, Klinikum Innenstadt, Medizinische KlinikUniversity of MunichMunichGermany

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