Three centuries of stomach symptoms in Scotland.
BACKGROUND
Stomach pain and discomfort have been reported since antiquity.


OBJECTIVE
To follow the time trends since the 18th century of dyspepsia, gastric ulcer, duodenal ulcer, and benign oesophageal disease to test when dyspepsia started to become a major clinical problem.


METHODS
The annual in- and out-patient records of the last three centuries from the Scottish Royal Infirmaries of Edinburgh, Aberdeen, Glasgow and Dundee were analysed. In addition, dispensary attendances, clinicians' casebooks, students' notebooks and medical texts have been scrutinized for historic statistics of upper gastrointestinal disease.


RESULTS
Dyspepsia was first recorded in the 1750s and increased markedly subsequently. Such dyspepsia persisted after gastric and duodenal ulcers appeared in the late 19th century and then declined again in the late 20th century. Non-ulcer dyspepsia has remained the commonest diagnosis made after endoscopy for stomach pain in the beginning of the 21st century.


CONCLUSIONS
The current commonest diagnosis of stomach pain, dyspepsia dates from the mid-18th century. Any explanations of its causation need to consider this timing.
Baron
J H
JH
Schools of Medicine of Imperial College, London and Mount Sinai, New York, NY, USA.
Watson
F
F
Sonnenberg
A
A
D000553:Ambulatory Care / Q000266:history; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000266:history; D004415:Dyspepsia / Q000453:epidemiology / Q000266:history; D004935:Esophageal Diseases / Q000453:epidemiology / Q000266:history; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000266:history*; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006760:Hospitalization; D006801:Humans; D008297:Male; D012606:Scotland / Q000453:epidemiology; D013276:Stomach Ulcer / Q000453:epidemiology / Q000266:history