Dyspepsia is upper abdominal pain or discomfort that is episodic or persistent and often associated with belching, bloating, heartburn, nausea or vomiting.1 The condition is reported to occur in approximately 25 percent (range: 13 to 40 percent) of the population each year, but most affected persons do not seek medical care.2,3 Nonetheless, dyspepsia is responsible for substantial health care costs (medications and diagnostic evaluations) and considerable time lost from work. Even though dyspepsia is a highly prevalent condition, no definitive studies have as yet established guidelines for the work-up of dyspeptic patients in the primary care setting.