In reply
We thank Dr Cammarota and his group for taking the time to comment on our recent study.1 The diagnosis of nonulcer dyspepsia was made on clinical grounds as described in our study.1 Patients without symptoms were not enrolled in the study; base upper endoscopy was performed only on symptomatic patients. Our cohort of subjects did involve patients referred to the gastrointestinal unit at San Francisco General Hospital, San Francisco, Calif. However, if this indeed represents a group with more severe symptoms than most, as suggested by Cammarota et al, any benefit from treatment would have been more likely to be detected by our study compared with a cohort with less severe symptoms.