Dyspepsia is a prevalent complaint in general and gastrointestinal clinics, with a prevalence of up to about 30% among adults in Iran. Dyspepsia is a complex condition, including upper gastrointestinal tract with chronic and recurrent symptoms, including epigastric pain, discomfort, including postprandial fullness and early satiety, which may overlap with heartburn and regurgitation . The symptoms of dyspepsia could be occurred due to an important structural pathology such as chronic peptic ulcer disease, gastroesophageal reflux, malignancy or it can also present as functional dyspepsia (without evidence of organic cause). Over 80% of the population are affected by dyspepsia at some time in their life  Worldwide investigations have shown that the prevalence of dyspepsia is in the range of 14.5-45%.

Only 75% of the dyspepsia experts, 73% of gastroenterologists and 59% of primary care providers adhere to dyspepsia best practices; so different medics have different views of dyspepsia. Providing of adequate treatment following common dyspepsia guidelines without a common diagnostic language may be unable. Comparing the prevalence rate of dyspepsia in different time periods or places is almost impossible due to the quick presentation of dyspepsia diagnostic criteria . Due to structural upper gastrointestinal (UGI) tract diseases like peptic ulcer, erosive esophagitis, luminal strictures and malignancy in structural dyspepsia esophagogastroduodenoscopy is the method of choice in differential diagnosis between structural and functional dyspepsia. It is possible that endoscopy is considered as the first approach in dyspepsia  the establishment of this procedure for every dyspeptic patient may not be a practical approach because it has burdensome expenses on health system. It should also be recognized that a large percentage of uninvestigated dyspepsia are functional cases. Therefore the use of endoscopy in uninvestigated dyspepsia is still a controversial subject in the world.

With Regards,
Sara Giselle
Associate Managing Editor
Global  Journal of Digestive Diseases