▁heter ogene ity ▁between ▁studies . ▁ ▁The ▁physical ▁exam ination ▁may ▁el ic it ▁ab dom inal ▁tend ern ess , ▁but ▁this ▁finding ▁is ▁n ons pec ific . ▁A ▁positive ▁Car nett ▁sign , ▁or ▁foc al ▁tend ern ess ▁that ▁increases ▁with ▁ab dom inal ▁wall ▁contra ction ▁and ▁pal p ation , ▁suggests ▁an ▁et i ology ▁involving ▁the ▁ab dom inal ▁wall ▁mus cul ature . ▁C ut aneous ▁der mat om al ▁distribution ▁of ▁pain ▁may ▁suggest ▁a ▁thor ac ic ▁poly rad icul op ath y . ▁Th ump ▁tend ern ess ▁over ▁the ▁right ▁upper ▁quadr ant ▁may ▁suggest ▁chron ic ▁ch ole c yst itis . ▁ ▁C ause ▁When ▁d ys pe ps ia ▁can ▁be ▁attributed ▁to ▁a ▁specific ▁cause , ▁the ▁majority ▁of ▁cases ▁concern ▁g astro es oph age al ▁re fl ux ▁disease ▁( GER D ) ▁and ▁g astr itis ▁disease . ▁Less ▁common ▁causes ▁include ▁pe ptic ▁ul cer , ▁g astr ic ▁cancer , ▁es oph age al ▁cancer , ▁co el iac ▁disease , ▁food ▁aller gy , ▁infl am mat ory ▁bow el ▁disease , ▁chron ic ▁int est inal ▁is chem ia ▁and ▁g astro par esis . ▁ ▁Non - ul cer ▁ind ig estion ▁ ▁In ▁about ▁ 5 0 - 7 0 % ▁of ▁people ▁with ▁d ys pe ps ia , ▁no ▁definite ▁organ ic ▁cause ▁can ▁be ▁determined . ▁In ▁this ▁case , ▁d ys pe ps