An otherwise normal female patient presents with symptoms of flatulent dyspepsia. She was staed on proton pump inhibitors, which controlled her symptoms. The next step in management of this condition should be

Flatulent Dyspepsia Flatulent dyspepsia is usually described as symptom of gallstone disease. However, flatulent dyspepsiab(in an otherwise normal female), that responds to PPI is more likely to result from reflux or peptic ulcer disease(rather than gallstone disease) and does not require surgical management or invasive investigations for gallbladder disease Patients with these symptoms should be observed (Wait and watch) or investigated by endoscopy to exclude reflux or peptic ulcer disease Ref: Sabiston 20th edition Pgno :1497