Who consults with dyspepsia? Results from a longitudinal 10-yr follow-up study.
OBJECTIVE
Dyspepsia is common, and the condition is often chronic, with a relapsing and remitting nature. Factors influencing the decision to consult a physician with symptoms remain unclear.


METHODS
The authors conducted a 10-yr follow-up longitudinal survey of individuals originally involved in a community-screening program for Helicobacter pylori (H. pylori). All surviving, traceable participants were contacted by validated postal dyspepsia questionnaire. Baseline demographic data, dyspepsia and irritable bowel syndrome (IBS) symptom data, and quality of life at study entry were already on file. Consent to examine primary care records was requested, and data regarding nonsteroidal anti-inflammatory drug and aspirin use, and dyspepsia and IBS-related consultations over the 10-yr study period were extracted from these.


RESULTS
Of 8,407 individuals originally involved, 3,266 (39%) gave consent to examination of primary care records. The mean age of included individuals was 55 yr, and 1,467 (45%) were male. 1,738 (53%) had dyspepsia, and 729 (42%) of these consulted a primary care physician as a result. Following multivariate logistic regression, H. pylori infection (odds ratio [OR] 1.76, 99% confidence interval [CI] 1.30-2.39), lower socioeconomic status (OR 1.68, 99% CI 1.02-2.76), frequent (OR 2.61, 99% CI 1.69-4.01) or severe (OR 1.87, 99% CI 0.99-3.52) symptoms, and increasing age (OR per year 1.06, 99% CI 1.0-1.11) were independent risk factors for consultation.


CONCLUSIONS
Reasons for consulting a physician with dyspepsia are multifactorial, but H. pylori infection, lower socioeconomic status, frequent or severe symptoms, and increasing age are independent predictors of consultation.
Ford
Alexander C
AC
Centre for Digestive Diseases, Leeds General Infirmary, Leeds, United Kingdom.
Forman
David
D
Bailey
Alastair G
AG
Cook
Michael B
MB
Axon
Anthony T R
AT
Moayyedi
Paul
P
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D016009:Chi-Square Distribution; D004415:Dyspepsia / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
D000894:Anti-Inflammatory Agents, Non-Steroidal