Prevalence Of Uninvestigated Dyspepsia Research Articles

Association between Dietary Macronutrient Intake and Symptoms in Uninvestigated Dyspepsia: Evidence from a Population-Based, Cross-Sectional Study.

(1) Background: Limited evidence from laboratory-based studies suggests that specific dietary macronutrients, particularly fat, can induce dyspeptic symptoms. Through a population-based study, we investigated the relationship between dietary macronutrients and dyspeptic symptoms and sought to determine macronutrient intake thresholds to predict or prevent dyspepsia and reduce symptoms in patients with dyspepsia. (2) Methods: A total of 4763 Iranian people were enrolled in this population-based, cross-sectional study. Uninvestigated dyspepsia (UD) and its symptoms, including postprandial fullness, early satiation, and epigastric pain, were evaluated using a modified Persian version of the Rome III criteria. The dietary intakes of participants were evaluated using a validated food–frequency questionnaire. Receiver operating characteristic (ROC) curve analysis was used to calculate threshold intakes of dietary macronutrients to prevent UD in the general population. The analysis was then repeated in those with UD to calculate intake thresholds for reducing UD symptoms. (3) Results: Early satiation occurred in 6.3% (n = 302), postprandial fullness in 8.0% (n = 384) and epigastric pain in 7.8% (n = 371) of participants. The prevalence of UD was 15.2%. Compared with individuals without UD, those with UD had a lower intake of carbohydrates (48.2% vs. 49.1%) and a higher intake of fats (38.3% vs. 37.4%), while protein and energy intakes did not differ. Higher dietary fat and protein intakes were associated with a higher prevalence of postprandial fullness and epigastric pain, respectively. Macronutrient intakes to predict UD in the general population were <49% of energy from carbohydrates, >14.7% from protein, and >37.7% from fats. Carbohydrate, protein, and fat intakes to prevent symptoms among those with UD were calculated to be >48.2%, <14.6%, and <38.6%, respectively. (4) Conclusion: Higher carbohydrate intake and lower fat or protein intakes were associated with a lower likelihood of UD. Prospective studies carefully manipulating dietary macronutrient composition are warranted to investigate the value of dietary changes to improve symptoms in people with UD.

The prevalence of uninvestigated dyspepsia and the association of physical exercise with quality of life of uninvestigated dyspepsia patients in Indonesia: An internet-based survey.

Epidemiological data on the prevalence of uninvestigated dyspepsia (UD) and its impact on the health-related quality of life (HRQOL) in Indonesian population are still lacking. There is no study investigating the association between exercise and the HRQOL in UD patients. We aimed to investigate the prevalence of UD and its association with physical exercise, and its impact on HRQOL in Indonesian patients with UD. This was a population-based, cross-sectional study, conducted using an internet-based questionnaire which was randomly distributed throughout Indonesia using the social media. The questionnaire contained socio-demographic details, exercise levels, Rome III criteria for dyspepsia, and SF-NDI (Short Form-Nepean Dyspepsia Index). The frequency, duration, the intensity of exercise, and the classification of exercise according to ACSM (American College of Sports Medicine) were included in the assessment. The screening for UD was conducted using the Rome III criteria and the SF-NDI score was calculated to assess the HRQOL in patients with UD. A total of 2725 valid responses were collected. The overall prevalence of UD in the study was 49.75%. Multiple logistic regression analysis showed that gender (female) and lack of exercise were independently associated with UD (OR 2.07, 95% CI 1.74-2.47, p < 0.001 and OR 1.72, 95% CI 1.42-2.07, p <0.001). The median SF-NDI score among 1295 UD subjects in non-exercising and exercising groups was 21.00 and 18.00 (p <0.001), respectively. This study demonstrated the prevalence of UD and the association between exercise and HRQOL among UD patients in Indonesia.

Modern aspects of the pathogenesis and treatment of dyspepsia

A review of current data suggests that the attention to the problem of dyspepsia is huge. The definition of functional dyspepsia was given in the Rome IV criteria, according to which two of its main options are distinguished – epigastric pain syndrome and postprandial distress syndrome. The term “uninvestigated dyspepsia” is important, which means the presence of dyspepsia symptoms in patients who have not performed diagnostic procedures to identify the organic causes of the pathology. The prevalence of uninvestigated dyspepsia in the world is about 21%. The prevalence of functional dyspepsia is significantly lower than the prevalence of uninvestigated dyspepsia and fluctuates around 10%. The risk factors for dyspepsia are usually tobacco smoking, non-steroidal anti-inflammatory drugs and/or aspirin, and Helicobacter pylori infection. The concept of the pathogenesis of functional dyspepsia undergoes significant changes. By analogy with the pathophysiology of irritable bowel syndrome, lesions of the relationship between the modulation of the cerebral cortex and the signal system of the gastroduodenal zone, the association of sluggish immune inflammation in the duodenum with motility and sensory activity of the stomach are most actively studied. The treatment of functional dyspepsia is a complex problem and changes after new ideas about its pathogenesis. Modern meta-analyzes have made it possible to expand the indications for the proton pump inhibitors administration, which can be actively used not only for the treatment of epigastric pain syndrome, but also for postprandial distress syndrome. Along with the required Helicobacter pylori eradication, there are reasons for the use of probiotics and antibiotics for the dyspepsia treatment.

Распространенность, факторы риска и этнические особенности неисследованной диспепсии

Background: in our country, studies on the prevalence of dyspepsia performed using the Rome IV criteria are rare, which makes it difficult to objectively compare Russian and international data, including ethnic characteristics. Aim: to study the prevalence and risk factors of uninvestigated dyspepsia in indigenous and foreign residents in rural areas of the Republic of Khakassia. Patients and Methods: continuous epidemiological screening (coverage 93.4%) of dyspepsia was performed in the villages Matur, Anchul, Verchnii Kurlugash, Nizhnie Siry, Bolshoy Bor, Bolshaya Seya, Verkhnyaya Seya, Inchul, Verkhnii Tashtyp of the Tashtyp district. A total of 2,080 newly-arrived residents (Caucasians, 911 males, average age 43.6 years) and 2,117 indigenous residents (Khakas, 978 males, average age 42.9 years) were surveyed. Dyspepsia was studied in accordance with the recommendations of the Rome IV criteria. Epigastric pain syndrome and postprandial distress syndrome were distinguished. Due to the fact that endoscopic examination of patients was not used, dyspepsia was considered as uninvestigated dyspepsia. The presence of Helicobacter pylori was determined serologically in 566 Caucasians and 533 Khakas. The results of clinical examination and interview (social status, complaints, medical history) were recorded in the standard questionnaires. Results: uninvestigated dyspepsia was diagnosed in 24.6% of Caucasians and 19.2% of Khakas (p&lt;0.001). Gender did not affect the prevalence of dyspepsia in Khakas. Among Caucasians, there was a tendency to more common detection of dyspepsia in women. The pain variant of dyspepsia prevailed in men in both populations. The incidence of postprandial distress syndrome among Caucasians was significantly higher in women. Other risk factors for dyspepsia in both populations were the following: age older than 50, Helicobacter pylori infection, smoking 20 or more cigarettes per day for more than 10 years, history of gallbladder pathology, acute viral hepatitis and helminthiasis. Conclusion: the data obtained allow to consider the influence of ethnicity on the prevalence of uninvestigated dyspepsia, including depending on gender identity. KEYWORDS: uninvestigated dyspepsia, ethnic characteristics, Helicobacter pylori, prevalence, risk factors. FOR CITATION: Tsukanov V.V., Vasyutin A.V., Tonkikh Yu.L. Prevalence, risk factors, and ethnic characteristics of uninvestigated dyspepsia. Russian Medical Inquiry. 2020;4(5):264–267. DOI: 10.32364/2587–6821–2020–4-5-263-267.

Factors associated with uninvestigated dyspepsia in students at 4 Latin American schools of medicine: A multicenter study

Introduction and aimsDyspepsia is a multifactorial disease that can involve alcohol, tobacco, or nonsteroidal anti-inflammatory drug use, as well as lifestyle, diet, socioeconomic elements, or psychologic factors. The aim of the present article was to establish the frequency of uninvestigated dyspepsia and determine its associated factors in students at 4 Latin American schools of medicine. Materials and methodsA cross-sectional, analytic study was conducted, in which a survey made up of closed-ended questions was applied at just one point in time. The association between the variables was then analyzed. A new questionnaire for the diagnosis of dyspepsia was one of the tests utilized to diagnose uninvestigated dyspepsia. Generalized linear models were used for the bivariate and multivariate analyses, employing the Poisson model with the log link function, obtaining crude prevalence ratios, adjusted prevalence ratios, and their 95% confidence intervals. ResultsOf the 1,241 individuals surveyed, 54% (841) were females and the median age was 21 years (range: 19-23 years). Prevalence of uninvestigated dyspepsia was 46%. The factors that had a direct association with dyspepsia were: depression, difficulty sleeping, and coffee consumption. On the contrary, eating regularly in a boarding house and the male sex had an inverse association. ConclusionsUninvestigated dyspepsia frequency was high in students at 4 Latin American schools. Depression, difficulty sleeping, and steady coffee drinking were factors directly associated with dyspepsia, whereas male sex and eating out at regular hours were factors with a reverse association. Therefore, we recommend that universities implement early detection programs for this highly preventable pathology.

Uninvestigated dyspepsia and associated factors of patients with gastrointestinal disorders in Dessie Referral Hospital, Northeast Ethiopia

BackgroundDyspepsia is a common problem in the community and clinical practice with symptom(s) considered arising from the gastroduodenal region. Dyspepsia burden and associated factors vary from country to country. The aim of this study was to determine the prevalence of uninvestigated dyspepsia (UD) using Rome III criteria, associated risk factors and self-reported dyspepsia symptoms’ correlation with H. pylori infection.MethodsA cross-sectional study was conducted among randomly selected 318 out patients with gastrointestinal complaints during the period from September 1 to December 30, 2015. All patients completed a questionnaire for collecting data regarding sociodemographic, lifestyle and functional gastrointestinal disorders. Diagnosis of dyspepsia was made according to the Rome III criteria. H. pylori infection was assessed using stool antigen test. SPSS version 20.0 statistical software package was used for data analysis.ResultsFrom a total of 318 patients, 48.4% had UD according to Rome III criteria; with 42.1% symptoms of epigastric pain/burning, 26.1% postprandial fullness and 22.6% early satiation. Epigastric pain/burning (AOR = 1.92, 95% CI 1.07–3.43), early satiation (AOR = 2.68, 95% CI 1.38–5.20) and belching (AOR = 4.7, 95% CI 1.54–14.40) were significantly correlated with H. pylori infection. H. pylori infection (AOR = 4.33, 95% CI 2.41–7.76) and aspirin/NSAIDs consumption (AOR = 5.29, 95% CI 2.82–9.93) were independent risk factors for UD. However, consumption of raw fruits/ vegetables at least once a week (AOR = 0.48, 95% CI 0.24–0.98) and taking two or more cups of tea a day (AOR = 0.339, 95% CI 0.17–0.70) were inversely associated with UD.ConclusionsUD is highly prevalent among adults with gastrointestinal complaints. H. pylori infection is significantly associated with UD and correlates with its symptoms. Individuals with epigastric pain/burning, early satiation and belching should be primary focus of H. pylori infection diagnosis and treatment. The role of consumption of tea, raw fruits and vegetables on dyspepsia needs further large scale study.

Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

Objectives: Dyspepsia is a common gastrointestinal (GI) symptom which impacts negatively on quality of life, workplace efficiency and overall productivity. Many studies on dyspepsia in our environment are hospital based, but being a complaint frequently treated first by self-medication before presentation to the hospital, such studies may underestimate its prevalence. The objective of the study was to determine the prevalence of the dyspepsia and its associated factors among administrative staff of the College of Health Sciences, University of Ilorin, Nigeria.Methods: This was a cross-sectional study. Pretested structured, close-ended, interviewer-administered questionnaires were administered to 53 administrative staff selected across the different units by stratified random sampling. The questionnaire obtained information about subject's experiences of dyspeptic symptoms and presence of associated factors such as family history, non-steroidal anti-inflammatory drugs (NSAIDS), tobacco and alcohol use, and presence of diabetes mellitus (DM).Results: The prevalence of uninvestigated dyspepsia among the respondents was 37.5%. Age was significantly predictive of the occurrence of dyspepsia among the subjects Odds Ratio- 1.46, 95% Confidence Interval (1.042-2.045) P=0.03. Use of NSAIDS, presence of DM, family history and tobacco use were not predictive of occurrence of dyspepsia.Conclusion: The prevalence of dyspepsia is high among respondents in the study.Keywords: Dyspepsia, prevalence, university, Nigeria

The speed of eating and functional dyspepsia

Background: dyspepsia is a common complaint, affecting about 26-41% of the general population. Investigations fail to identify organic cause in 50%–60% of functional dyspepsia. Little informations are available about whether quick eating is one of the risk factors for functional dyspepsia (FD).Objectives: To study the association between quick eating and FD.Materials and methods: The study was performed on 132 resident doctors in the medical city/Baghdad, by introducing a questionnaire derived from the Rome III criteria for diagnosis of FD and its subtypes and calculating the average daily meal duration for each one. The subjects were all Arabian, Iraqi, white resident doctors sharing the same type and amount of food. We excluded those with history of alcoholism, chronic NSAID use, documented organic gastrointestinal lesion, or with alarm features of dyspepsia , chronic systemic disease or previous history of dyspepsia.Results: The prevalence of uninvestigated dyspepsia (UD) was 37.88%, post-prandial distress syndrome (PPD): 16.67%, and epigastria pain syndrome (EPS):12.12%.Quick eating (independently on the BMI) was significantly associated with higher prevalence of FD and EPS, but not PPD. Higher BMI was associated with higher prevalence of FD and PPD (not EPS), smoking was associated with higher prevalence of FD and both subtypes, while age and gender had no effect on the prevalence of each.Conclusion: prevalence of UD increases in quick eaters regardless the BMI, Smoking and higher BMI also increase the UD prevalence.

Epidemiology of Uninvestigated Dyspepsia and Functional Dyspepsia in Asia

Functional dyspepsia (FD) is a group of gastrointestinal (GI) disorders that includes variable combinations of chronic or recurrent upper GI symptoms not explained by structural or biochemical abnormalities. FD accounts for a significant percentage of patients seen in primary care with abdominal symptoms. Although the criteria used to define FD can easily affect the prevalence in the general population, the prevalence of uninvestigated dyspepsia and FD diagnosed by the Rome III criteria is 5.3% to 20.4%, predominantly affecting females. The prevalence differs among geographical regions and races. Gene polymorphisms and early life events are also involved in the development of FD. The symptoms often alleviate and re‐appear in the course of these entities. This information may introduce physicians to the detailed background of these patients and strategies for treatment.

Offshore training in navy personnel is associated with uninvestigated dyspepsia.

To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.

Prevalence of uninvestigated dyspepsia and gastroesophageal reflux disease in Korea: a population-based study using the Rome III criteria.

There have been few population-based studies on the prevalences of gastroesophageal reflux disease (GERD) and dyspepsia using Rome III criteria in Asian countries. A population-based, cross-sectional study was conducted by telephone interviews of 5,000 Koreans between the ages of 20-69years. Gastrointestinal symptoms were assessed by a translated Korean version of Rome III criteria. Uninvestigated dyspepsia (UID) was defined by symptom criteria of Rome III. GERD was defined by troublesome heartburn and/or acid regurgitation occurring at least once a week. The EQ5D assessment tool was used for the evaluation of quality of life. The prevalences of UID, postprandial distress syndrome (PDS), and epigastric pain syndrome (EPS) were 7.7, 5.6, and 4.2%, respectively. Overlap between PDS and EPS was found in 27.1% (104/384) of subjects with UID. There were no significant differences in demographic variables between patients with PDS and EPS. The prevalence of GERD was 7.1%. Overlap between GERD and UID was found in 50.0% of GERD patients. The EQ5D index of patients without either UID or GERD was 0.92±0.07, and those of patients with only UID, with only GERD, and with both UID and GERD were 0.88±0.09, 0.88±0.11, and 0.84±0.15, respectively. GERD and UID based on Rome III criteria were prevalent and significantly affected the quality of life in Korea. In Korean patients with UID, there was considerable overlap and there were no significant differences in demographic variables between PDS and EPS.

Chronic gastrointestinal symptoms and quality of life in the Korean population.

To evaluate the prevalence of chronic gastrointestinal symptoms and their impact on health-related quality of life (HRQOL) in the Korean population. A cross-sectional survey, using a reliable and valid Rome II based questionnaire, was performed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey (SF-36). Of the 1807 eligible subjects, 1417 (78.4%: male 762; female 655) were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastroesophageal reflux disease (GERD), defined as heartburn and/or acid regurgitation experienced at least weekly, was 3.5% (95% CI, 2.6-4.5). The prevalence of uninvestigated dyspepsia, irritable bowel syndrome (IBS) and chronic constipation based on Rome II criteria were 11.7% (95% CI, 10.1-13.5), 2.2% (95% CI, 1.5-3.1), and 2.6% (95% CI, 1.8-3.5) respectively. Compared with subjects without chronic gastrointestinal symptoms (n=1153), those with GERD (n=50), uninvestigated dyspepsia (n=166) and IBS (n=31) had significantly worse scores on most domains of the SF-36 scales. The prevalence of GERD, uninvestigated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health-related quality of life was significantly impaired in subjects with GERD, uninvestigated dyspepsia and IBS in this community.

Prevalence of Gastroesophageal Reflux Disease Symptoms and Uninvestigated Dyspepsia in Korea: A Population-Based Study

Various reports on the prevalence of gastroesophageal reflux disease (GERD) and uninvestigated dyspepsia have been conducted in Western countries. We sought to determine the frequency of GERD symptoms and uninvestigated dyspepsia in Korea. Telephone interviews were conducted with 1,044 individuals. Of all subjects, 7.1% reported that GERD symptoms were present at least once a week, and 3.8% at least twice a week. The prevalence of heartburn according to educational level and acid regurgitation according to age was significantly different (P < 0.05). The prevalence of uninvestigated dyspepsia was reported as 12.2%. Dyspepsia was divided into subgroups of 34% ulcer-like, 56% dysmotility-like, and 10% nonspecific. The occurrence of dyspepsia did not vary according to age, gender, educational level and household income. As frequency of GERD symptoms increased, quality of life significantly decreased. We concluded that GERD symptoms and uninvestigated dyspepsia were prevalent in Korea. The prevalence was similar to that of other Asian countries.

Epidemiology of functional dyspepsia: A global perspective

Dyspepsia refers to group of upper gastrointestinal symptoms that occur commonly in adults. Dyspepsia is known to result from organic causes, but the majority of patients suffer from non-ulcer or functional dyspepsia. Epidemiological data from population-based studies of various geographical locations have been reviewed, as they provide more realistic information. Population-based studies on true functional dyspepsia (FD) are few, due to the logistic difficulties of excluding structural disease in large numbers of people. Globally, the prevalence of uninvestigated dyspepsia (UD) varies between 7%-45%, depending on definition used and geographical location, whilst the prevalence of FD has been noted to vary between 11%-29.2%. Risk factors for FD have been shown to include females and underlying psychological disturbances, whilst environmental/ lifestyle habits such as poor socio-economic status, smoking, increased caffeine intake and ingestion of non-steroidal anti-inflammatory drugs appear to be more relevant to UD. It is clear that dyspepsia and FD in particular are common conditions globally, affecting most populations, regardless of location.

Systemic review: the prevalence and clinical course of functional dyspepsia.

To examine the prevalence of functional dyspepsia in the general population, and to evaluate the natural history/clinical course of patients with functional dyspepsia. Full-length published manuscripts during 1980-2002 were included if: (i) participants had uninvestigated or functional dyspepsia; (ii) dyspepsia was defined; (iii) for prevalence, population-based samples were evaluated; (iv) for prognosis, the total number of the inception cohort and the total number of individuals available at the end of follow-up were reported. Twenty-two studies (1976-2002) that examined the prevalence of dyspepsia fulfilled the inclusion and exclusion criteria; 17 studies examined more than 1000 participants, but only two studies provided information sufficient to calculate the prevalence of functional dyspepsia (11.5-14.7%). The prevalence of uninvestigated dyspepsia was in the range 10-40%. When the definition of dyspepsia was restricted to participants with upper abdominal pain, irrespective of the presence of heartburn or acid regurgitation, the prevalence rate estimate was 5-12%. Thirteen studies examined the clinical course of functional dyspepsia (seven retrospective and six prospective). Sample sizes were small (n = 35-209). A follow-up ascertainment of symptoms amongst individuals in the original cohorts was obtained in 92.5-98.2% of prospective studies and in 67.7-82.2% of retrospective studies. The follow-up duration was in the range 1.5-10 years for prospective studies and 5-27 years for retrospective studies; the median follow-up duration for all studies was approximately 5 years. A variable prognosis was reported. An outcome of symptom improvement or becoming asymptomatic was reported in at least one-half of patients in 10 of the 13 studies, and in at least two-thirds of patients in six of the 13 studies. Prognostic factors were inconsistent and, in general, poorly described. Functional dyspepsia is prevalent world-wide, but the prognosis remains poorly defined. There is a need for population-based studies to examine the prevalence and clinical course of documented functional dyspepsia.