Etiological and patogenetic classification of maldigestive syndrome and peculiarities of cavity and membrane's digestion insufficiency clinical features are presented in this paper. The methods of laboratory's and instrumental diagnosis and differential diagnosis of maldigestion and malabsorbtion are discussed. Differential use of different enzyme's preparations and the possibility of reverse pancreatic function suppression during its long use are discussed as well.

Ninety patients and 30 senior hospital doctors were questioned about indigestion and dyspepsia. There were marked discrepancies between the views of patients and doctors. Most doctors considered indigestion to be synonymous with dyspepsia and associated it with peptic ulcer. Patients, however, were not generally conversant with the term dyspepsia and linked indigestion with psychological factors, feeding patterns and bowel function rather than physical illness. The patients' concept of indigestion corresponded closely with medically-accepted features of irritable bowel syndrome. Uncritical use of these terms may lead to misinterpretation of the patient's complaint and inappropriate management.

Dyspepsia affects a large percentage of the general population and can lead to lost work productivity and reduced quality of life. Patients with dyspepsia younger than 60 should not routinely undergo endoscopy but instead should pursue Helicobacter pylori test-and-treat approach. For patients 60 and older, endoscopy should be performed. Patients without any identifiable cause for their symptoms are diagnosed with functional dyspepsia. Guideline-based treatment includes H pylori eradication and proton pump inhibitor use. If acid suppression is not adequate, treatment with a tricyclic antidepressant followed by a prokinetic agent and psychological therapy are considered. Complementary therapies are not recommended due to limited evidence.

Keywords: Dyspepsia; Epigastric pain syndrome; Functional dyspepsia; Helicobacter pylori test and treat; Post-prandial distress syndrome.