DYSPEPSIA

Initial poor quality of life and new onset of dyspepsia: results from a longitudinal 10-year follow-up study

Alexander C Ford¹, David Forman², Alastair G Bailey¹, Anthony T R Axon¹, Paul Moayyedi²

¹ Centre for Digestive Diseases, Leeds General Infirmary, Leeds, UK
² Centre for Epidemiology and Biostatistics, Medical School, Leeds University, Leeds, UK
³ Gastroenterology Division, McMaster University, Health Sciences Centre, Hamilton, Ontario, Canada

Correspondence to:
Dr A C Ford
Room 7.23, Department of Academic Medicine, Clinical Sciences Building, St James’s University Hospital, Leeds LS9 7TF, UK;alexf12399{at}yahoo.com

Background: Numerous studies examining the prevalence and natural history of dyspepsia in the general population have been conducted. However, few have reported the effect of quality of life on the development of dyspepsia. A 10-year longitudinal follow-up study examining the effect of quality of life on subsequent dyspepsia was performed.

Methods: Individuals originally enrolled in a population-screening programme for Helicobacter pylori were contacted through a validated postal dyspepsia questionnaire. Baseline demographic data, quality of life at original study entry, and dyspepsia and irritable bowel syndrome (IBS) symptom data were already on file. Consent to examine primary-care records was sought, and data regarding non-steroidal anti-inflammatory drugs (NSAID) and aspirin use were obtained from these.

Results: Of 8407 individuals originally involved, 3912 (46.5%) provided symptom data at baseline and 10-year follow-up. Of 2550 (65%) individuals asymptomatic at study entry, 717 (28%) developed new-onset dyspepsia at 10 years, an incidence of 2.8% per year. After multivariate logistic regression, lower quality of life at study entry (OR 2.63; 99% CI 1.86 to 3.71), higher body mass index (OR per unit 1.05; 99% CI 1.02 to 1.08), presence of IBS at study entry (OR 3.1; 99% CI 1.51 to 6.37) and use of NSAIDs and/or aspirin (OR 1.32; 99% CI 0.99 to 1.75) were significant risk factors for new-onset dyspepsia.

Conclusions: The incidence of new-onset dyspepsia was almost 3% per year. Low quality of life at baseline exerted a strong effect on the likelihood of developing dyspepsia at 10 years.

Abbreviations: BMI, body mass index; BSG, British Society of Gastroenterology; IBS, irritable bowel syndrome; LDQ, Leeds Dyspepsia Questionnaire; NSAID, non-steroidal anti-inflammatory drug; PAR%, population attributable risk percentage; PGWBI, Psychological and General Well-Being Index; S-FLDQ, Short-Form Leeds Dyspepsia Questionnaire

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