Therapy for nonulcer dyspepsia has largely been empiric because effective therapeutic agents are sparse and therapeutic trials show inconsistent results. The Cochrane collaboration has reviewed this matter and came to the conclusion that prokinetics and acid-suppression therapy might have a significant, although small, clinical benefit over placebo. Although the role of Helicobacter pylori in nonulcer dyspepsia is still a matter of controversy, one meta-analysis suggests that in H. pylori–positive dyspeptic patients, H. pylori eradication has a small but significant therapeutic benefit over a therapy that does not eradicate H. pylori. Other aspects of pathophysiology of nonulcer dyspepsia that have been studied in the past year include visceral hyperalgesia and abnormal sleep pattern. New studies have also investigated the clinical presentation of nonulcer dyspepsia and the possible reasons why some patients never consult a doctor whereas others do so frequently.
*Universitätsklinik für Innere Medizin IV, AKH Wien, Abteilung für Gastroenterologie und Hepatologie, Vienna, Austria.
Correspondence to N. J. Talley MD, PhD, Department of Medicine, University of Sydney, Nepean Hospital, P.O. Box 63 Penrith, NSW 2751, Australia