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Dyspepsia, typically presenting as heartburn or gastrointestinal discomfort, is responsible for about 2-5% of patient visits to general health care physicians. In over 50% of cases, no firm diagnosis is possible because symptoms are of an uncertain origin. However, a significant proportion of patients with early gastric cancer experience symptoms typical of dyspepsia.
Following the availability of H2 receptor antagonists such as cimetidine, famotidine, nizatidine and ranitidine to treat gastric ulcer, it became evident that their use could mask symptoms of cancer and delay diagnosis and appropriate treatment (1). Furthermore, the recently introduced and more powerful proton pump inhibitors such as omeprazole, lansoprazole, and pantoprazole produce significantly more rapid symptom control and healing of benign gastric ulcer.
It...