Non-ulcer dyspepsia is a highly prevalent medical condition affecting up to 30 percent of the Western population, accounting for 2-5 percent of all adult visits to primary care physicians and leads to over one billion dollars worth of upper endoscopy procedures per year. In an attempt to lower this tremendous burden on the health care system the general practice currently is to attempt to avoid endoscopy in the majority of patients, which are at low risk, by an initial empirical trial of medication. Endoscopy can then be performed in those that fail initial therapy. Unfortunately, empirical treatment is only effective in about 40-50 percent of cases since it is difficult to determine in advance the most effective treatment. Consequently, the high cost of endoscopy continues to be a problem. The overall goal of this proposal is to develop an inexpensive, non-invasive test for the objective and quantitative categorization of non-ulcer dyspepsia patients with the purpose of providing the most effective initial treatment. Effective initial treatment is the single most important action to limit the unnecessary use of expensive investigative procedures, such as upper endoscopy.
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