Imaging studies in dyspepsia

Patients with functional dyspepsia have discomfort centred in the upper abd omen in the absence of oesophagitis, ulcer, cancer or other pathology which could have explained the dyspepsia. It is generally accepted that neither endoscopy, nor other imaging modalities give any positive findings supporti ng the diagnosis. However, recent investigations have shown that both endos copic and ultrasonographic imaging show changes: erosive prepyloric changes (EPC) and accommodation abnormalities, respectively, in a high percentage of the patients. The diagnostic sensitivity and specificity of the changes are not yet known, but the fact that they are also seen in several other co nditions characterised by dyspepsia, for instance in gallstone disease, may simply indicate that they are linked to epigastric discomfort in general, and not to a specific dyspeptic condition. Ultrasonographic imaging is a no n-invasive, widely available, convenient, and reliable method for evaluatio n of gastric emptying, gastric motility, transpyloric flow and accommodatio n disturbances, which may play a crucial role in the pathogenesis of dyspep sia.