Nonulcer

Nonulcer is a medical descriptor used to indicate the absence of ulcers in a given condition or area. In gastroenterology, the term is most often encountered in reference to dyspepsia conditions where upper abdominal symptoms occur without endoscopic evidence of gastric or duodenal ulcers. The phrase nonulcer dyspepsia is commonly used, though many clinicians now prefer the term functional dyspepsia, which emphasizes functional rather than structural causes after ulceration has been excluded.

Clinical features associated with nonulcer or functional dyspepsia include chronic upper abdominal discomfort or pain, early satiety, fullness after meals, bloating, nausea, and sometimes belching. Symptoms are typically intermittent and do not correspond to a single identifiable mucosal lesion, and patients usually do not have alarm features such as weight loss, persistent vomiting, or GI bleeding.

Diagnosis involves ruling out ulcer disease and other pathology. This often includes endoscopy to exclude mucosal breaks, ulcers, or tumors, along with noninvasive testing for Helicobacter pylori and targeted laboratory studies as indicated. Functional dyspepsia is diagnosed when symptoms persist without an organic cause that explains them, per criteria such as the Rome definitions.

Management focuses on symptom relief and often includes lifestyle modifications, dietary adjustments, and avoidance of NSAIDs. Pharmacologic options may include acid suppression (proton pump inhibitors or H2 blockers), prokinetics, and, in some cases, low-dose antidepressants or psychological therapies to address visceral hypersensitivity and psychosocial factors. The prognosis varies, but many patients experience improvement with appropriate treatment.