Dyspepsia in consulters and non-consulters

Abstract

Objectives To assess the prevalence of dyspepsia (defined as upper abdominal pain) and dyspepsia subgroups in a random community sample and to study the association between symptoms, potential risk factors (smoking, alcohol, analgesics) and health-care seeking behaviour. Design Population-based prospective study with standardized assessment of gastrointestinal symptoms, risk factors and health-care seeking, using a bowel disease questionnaire. Sample A total of 423 randomly selected population-based subjects and 100 consecutive outpatients referred for evaluation of upper abdominal symptoms. Results In the population-based sample, the prevalence of ulcer-like, dysmotility-like and reflux-like dyspepsia were 20.6% [95% confidence interval (CI), 16.7–24.4], 24.6% (95% CI, 20.5–28.7) and 21.0% (95% CI 17.2–24.9), respectively; 83% belonged to more than one category. Health-care seeking in the population-based sample was associated with both the severity and frequency of intestinal and non-intestinal symptoms, but only 28.0% (95% CI, 21.3–34.7) of symptomatic subjects had consulted a doctor for evaluation of abdominal symptoms. There was a significant association between dyspepsia and aspirin intake [odds ratio (OR), 2.4; 95% CI, 1.51–3.81]; dyspepsia was negatively associated with consumption of more than two alcoholic drinks per day (OR, 0.6; 95% CI, 0.33–0.94). Conclusions (1) Dyspepsia is common in the population but dividing subjects into dyspepsia subgroups is unhelpful. (2) Consulters, i.e., those who seek health-care, have more intense symptoms than non-consulters and (3) dyspepsia is associated with ingestion of aspirin.