Gastroenterology

Gastroenterology

Volume 138, Issue 4, April 2010, Pages 1302-1311
Gastroenterology

Clinical—Alimentary Tract
Epidemiology of Functional Dyspepsia and Subgroups in the Italian General Population: An Endoscopic Study

https://doi.org/10.1053/j.gastro.2009.12.057Get rights and content

Background & Aims

Population-based endoscopic studies are needed to assess the epidemiology of functional dyspepsia (FD) and the newly suggested subgroups of meal-related symptoms and epigastric pain. We evaluated the prevalence of, and risk factors for, FD in the Italian general population.

Methods

A total of 1533 inhabitants of 2 villages were invited to undergo symptom evaluation using a validated questionnaire, esophagogastroduodenoscopy, and 13C-urea breath test; 1033 subjects (67.4%) took part.

Results

Of the 1033 subjects, 156 (15.1%; 95% confidence interval [CI], 12.9–17.3) had dyspepsia, and of these 114 (11%; 95% CI, 9.2–12.9) had FD. Of the 114 subjects with FD, 77 (67.5%) had meal-related symptoms (postprandial fullness and/or early satiation) and 55 (48.2%) had epigastric pain. Only 18 subjects (15.8%) had both meal-related symptoms and epigastric pain; this was fewer than expected by chance alone (P < .001). Unemployment (odds ratio [OR], 5.80; 95% CI, 1.56–21.60), divorce (OR, 2.76; 95% CI, 1.10–6.91), smoking (OR, 1.74; 95% CI, 1.11–2.70), and irritable bowel syndrome (OR, 3.38; 95% CI, 1.85–6.19) were significantly associated with FD. Unemployment, divorce, and irritable bowel syndrome were associated with both meal-related symptoms and epigastric pain, while smoking was associated only with meal-related symptoms.

Conclusions

FD is present in 11% of the Italian general population. Unemployment and divorce seem to increase the risk of FD, and smoking seems to be associated with meal-related symptoms. Two distinct subgroups of FD, as suggested by Rome III, seem to exist in the general population.

Section snippets

Study Population

The study population was recruited from 2 Italian villages, Loiano and Monghidoro, as part of the Multicentre Italian Study on Cholelithiasis (MICOL), a population-based study including 2 cross-sectional surveys for the evaluation of the prevalence and incidence of gallstone disease.18 Details regarding sampling procedures of the population were reported elsewhere.19 Briefly, in the first MICOL survey, performed between 1985 and 1987, all 3547 inhabitants of the 2 villages aged 18 to 69 years

Prevalence of Dyspepsia and Functional Dyspepsia

Of the 1033 subjects, 156 (15.1%; 95% CI, 12.9–17.3) had dyspepsia, while the remaining 887 subjects were classified as having no dyspepsia. Of the 887 subjects, 174 had dyspeptic symptoms but did not meet the criteria of dyspepsia due to the presence of concomitant prominent reflux symptoms.

Of the 156 subjects with dyspepsia, 114 (73.1%) had functional dyspepsia, while 42 (26.9%) had structural lesions including esophagitis (n = 13; 9%), Barrett's esophagus (n = 2; 1.3%), peptic ulcer (n = 14

Discussion

This study showed a prevalence of dyspepsia in the Italian general population of 16% with a prevalence of functional dyspepsia of 11%. We found that unemployment, divorce, cigarette smoking, and IBS were significantly associated with dyspepsia and functional dyspepsia. Unemployment, divorce, and IBS were associated with both meal-related symptoms and epigastric pain, while smoking was associated only with meal-related symptoms. We also found that the subgroup of subjects with epigastric pain

Acknowledgments

The authors thank Drs D. Beretti, M. L. Bianchi, L. Ceroni, L. De Luca, S. Fossi, S. Maltoni, C. Martuzzi, G. Nicolini, P. Pozzato, and L. Ricciardiello for collaboration; Dr D. Panuccio, who was the head of the Unit of Internal Medicine of the Hospital of Loiano at the time of the study; and the primary care physicians of Loiano and Monghidoro—Drs De Stefano, L. Gaggioli, C. Gaggioli, and C. L. Navarra—for their help in coordinating the study.

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    Conflicts of interest The authors disclose no conflicts.

    Funding Supported by a grant from the “Fondazione del Monte di Bologna e Ravenna,” Italy.

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