What about diagnosing the patient with benign functional dyspepsia? In the past, lab tests and/or endoscopy were used to rule out ulcers, but dyspepsia is so common and diagnostic costs are so prohibitive that many physicians are managing patients with empirical therapy. And many patients are managing themselves with a trip to the drug store.One concern is that the availability of so many over-the-counter acid suppressants -- famotidine (Pepcid AC), cimetidine (Tagamet HB), and ranitidine (Zantac 75), as well as PeptoBismol and a large selection of antacids -- will allow patients to treat their own indigestion, which could be caused by H pylori infection and thus should be treated with antibiotics. When the urea breath test is available and diagnosing H pylori becomes a more routine part of medical care, self-diagnosis and self-treatment will be much less of a problem.
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