Dyspeptic symptoms are a common presenting complaint, and there is continuing debate about management. Acid suppressant drugs, the most potent of which are proton pump inhibitors, are often prescribed, and it has been suggested that proton pump inhibitors are probably too widely prescribed for minor symptoms, and the cost implications of this are clear. There is substantial, continuing, and unexplained rise in prescribing of proton pump inhibitors. It is unknown whether their use in practice has corresponded to their licensed indications.