Functional Dyspepsia

To the Editor: Talley and Ford (Nov. 5 issue)¹ omit chronic abdominal-wall pain, a common disorder that is often attributed to abdominal cutaneous-nerve entrapment,² as a possible cause of epigastric pain. Chronic abdominal-wall pain is often localized to the upper abdomen — for example, in 33.9%³ and 71.4%⁴ of patients in two series. Before diagnosis, patients typically have fruitless and costly health care visits, diagnostic tests, and drug therapy.^3,4Characteristic features of the pain² and physical-examination findings described nearly 90 years ago²⁵ underlie the diagnosis, which can be confirmed by the response to a local anesthetic injection.², . . .