Management of dyspepsia at the beginning of the twenty‐first century

Dyspepsia remains a frequent intercurrent management problem for the non‐gastroenterologist. However, the causes for dyspepsia have changed markedly in recent decades. In contrast to gastro‐oesophageal reflux ­disease, both gastro‐oesophageal malignancy and peptic ulcer disease have become uncommon causes for ­dyspepsia. Concurrent with these changes, management strategies for dyspepsia have changed. Once aware of these changes the non‐gastroenterologist can effectively manage the majority of patients with dyspepsia. The present paper reviews these key changes in dyspepsia management. (Intern Med J 2003; 33: 604−609)