A diagnostic study of patients with upper abdominal pain.

197 consecutive, non-acute, medical patients who presented with upper abdominal pain were subjected to a standard programme of investigation. The investigation represents an attempt to supplement general clinical experience with exact data. In about half the patients no cause of the pain was found and a diagnosis of X-ray negative dyspepsia was made by elimination. It is concluded that a special research effort is needed to explain the complaint in this large group of patients. Duodenal ulcer was twice as common as gastric ulcer, and two patients suffered from gastric cancer. The diagnostic value of the symptomatology was analysed, but only the relation of pain to meals was found to be of diagnostic interest. In particular, the probability of duodenal ulcer was low and that of X-ray negative dyspepsia high, if the pain was provoked by eating. The age, sex, and acid production also had diagnostic value.