Helicobacter pylori infection, intake of analgesics or anti-inflammatory medication, and personal factors in relation to dyspeptic symptoms in patients of a general practitioner.
BACKGROUND
Several studies have assessed the relationship between Helicobacter pylori infection and dyspeptic symptoms in highly selected patient populations and they have yielded inconsistent results.


OBJECTIVE
To investigate the relationship between current H. pylori infection, intake of analgesics or anti-inflammatory medication, and personal factors with dyspeptic symptoms in a large, unselected patient population of a general practitioner (GP).


METHODS
Consecutive patients of a GP were invited to participate in a cross-sectional study regardless of the reason for their visit. Active infection with H. pylori was measured using the 13C-urea breath test (13C-UBT). A standardised questionnaire covering demographic, socioeconomic and lifestyle factors, and dyspeptic symptoms was completed by the patients. The number and severity of dyspeptic symptoms were quantified using a symptom score.


RESULTS
Five hundred and one out of 531 eligible patients returned their questionnaires; a response rate of 94.4%. The prevalence of H. pylori infection, as indicated by a positive 13C-UBT, was 21.1% and was unrelated to dyspeptic symptoms. After adjustment for potential confounders by multiple logistic regression, a symptom score in the upper quartile of the symptom score distribution was significantly associated with female sex (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1 to 3.0) and intake of analgesics or anti-inflammatory drugs other than non-steroidal anti-inflammatory drugs (NSAIDs) (OR = 2.3, 95% CI = 1.1 to 4.7). Older age (60 to 79 years) was associated with fewer symptoms (OR = 0.4, 95% CI = 0.2 to 0.9) when compared with the youngest age group (15 to 39 years).


CONCLUSIONS
Female sex, younger age, and intake of analgesics or anti-inflammatory drugs other than NSAIDs, but not H. pylori infection, were independently associated with dyspeptic symptoms in this population.
Bode
G
G
Department of Epidemiology, University of Ulm, Germany. guenter.bode@medizin.uni-ulm.de
Brenner
H
H
Adler
G
G
Rothenbacher
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001944:Breath Tests / Q000379:methods; D004415:Dyspepsia / Q000150:complications; D005194:Family Practice; D005260:Female; D005858:Germany; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012307:Risk Factors
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal