“Functional” should not be shorthand for “I don't know” in dyspepsia

EDITOR—With reference to the article by Talley et al on dyspepsia, it is saddening to see the perpetuation of the term “functional” as shorthand for “I don't know the nature of the problem.”1 Dyspepsia is the commonest presenting gastrointestinal symptom. Dyspepsia of recent onset, sometimes accompanied by weight loss, rings alarm bells over the possibility of malignancy and dictates the need for endoscopy, but most patients do not fit this paradigm.

The commonest cause of non-malignant dyspepsia is gastro-oesophageal reflux. This is a true …