Defined by Rome III criteria as the presence of chronic dyspeptic symptoms (early satiation, postprandial fullness, or upper abdominal bloating) in the absence of underlying structural or metabolic disease.

Treatment:

• Inquiry into the patient’s medical, social, and family history.
• Rule out a recent change in diet or medications.
• Avoid over-testing, which reflects diagnostic uncertainty and affect patient’s confidence.
• Discuss the pathophysiology, including abnormalities of gut motility, heightened visceral sensation.
• Advice against caffeinated drinks, chocolate, smoking, and excessive alcohol.
• Maintain smaller meals.
• Advise patients with meal-related bloating, nausea or early satiety to have small, low fat meals.
• Therapeutic dose of PPI is superior to H2-receptor antagonist because of their superior acid suppression.
• Offer prokinetics to improve gastric accommodation and gastric emptying.
• Consider antidepressants or referral of patients with psychological problems, psychiatric problems, or history of physical or sexual abuse for psychological assessments or to the chronic pain management clinic.