Non-ulcer dyspepsia is an unsatisfactory term, as it describes a spectrum of conditions. The term is used for patients who have a normal upper endoscopy, macroscopically, but who have persistent upper gastrointestinal symptoms. Patients with non-ulcer dyspepsia respond to a wide variety of treatments, and there is a strong placebo response. Fifty per cent of these patients are shown to have Helicobacter pylori present if biopsy specimens are taken at endoscopy. Previous studies suggest that H. pylori eradication improves patients' symptoms. In a study from our unit we have shown that, in the short term, patients' symptoms improved with treatment, independent of H. pylori status. However, at 1-year follow-up, prolonged improvement of symptoms was observed only in patients in whom the organism had been eradicated.