Dyspepsia syndrome is most frequently associated with functional dyspepsia. Common causes of refractory to treatment dyspepsia syndrome are gastroduodenal ulcer, gastroesophageal reflux disease, Helicobacter pylori-associated dyspepsia and chronic pancreatitis (CP). The range of differential diagnostic search for refractory dyspepsia should also include hepatobiliary system diseases and cardiac pathology. The problem of CP timely diagnosis becomes particularly urgent due to the increase in the incidence and rejuvenation of this disease. This is particularly important because it is still possible to achieve a long-term disease remission at the stage of early CP, when, in fact, it is possible to talk about recovery. In contrast, progression can increase the adverse course of the disease, up to fatal outcome. For example, the standardized mortality rate for patients with confirmed CP was 4.3 times higher for men and 4.5 times higher for women in comparison with the general population. The article presents data about the prospects of early CP diagnosis on the basis of the currently available criteria, provides an algorithm of differential diagnostic search in refractory to treatment epigastric pain, which can find application in clinical practice.