EDITOR—Bashford et al report a 10-fold rise in prescriptions for proton pump inhibitors between 1991 and 1995, mainly because of increased unlicensed use for non-ulcer dyspepsia.1 Diagnosis of non-ulcer dyspepsia will be increased by the frequent use of ulcer healing drugs before referral for gastroscopy because these drugs reduce diagnostic yield.2

We audited 270 dyspeptic patients referred for gastroscopy to determine the ideal time to stop ulcer healing drugs before investigation. In all, 154 (57%) patients had taken ulcer healing drugs in the 3 months before gastroscopy; 77 of these received proton pump inhibitors. When we compared patients treated with ulcer healing drugs with those who had not taken these drugs in the 3 months before gastroscopy, treated subjects had a …