Do distinct dyspepsia subgroups exist in the community? A population-based study.
BACKGROUND
The heterogeneity of the dyspepsia symptom complex is well known. Several attempts to classify dyspepsia into subgroups have been proposed as a basis for diagnosis and therapy, but data are conflicting. We postulated that dyspepsia comprises three distinct subsets, characterized by pain, early satiety, or nausea/vomiting. We aimed to identify these subsets of dyspepsia: "frequent upper abdominal pain (UAP),""early satiety (ES)," and "nausea/vomiting (NV)."


METHODS
A population-based, cross-sectional survey study was conducted by mailing a valid questionnaire to an age- and gender-stratified random sample of residents of Olmsted County, MN, aged 20-94 yr (response rate 55%). Dyspepsia and irritable bowel syndrome (IBS) prevalence were estimated by Rome II criteria; gastroesophageal reflux (GERD) by weekly or more frequent heartburn or acid regurgitation. Dyspepsia subgroups were categorized based on a priori defined symptoms.


RESULTS
The prevalence (95% CI) of dyspepsia was 15% (14, 17). Of 351 dyspeptic subjects, 51% (46, 56) reported UAP, 21% (16, 25) NV, and 47% (42, 52) ES. The overlap of the subgroups was significantly less than expected by chance. Among the three groups, the subjects were similar in age, educational level, IBS status, and overall symptom severity. A high somatic symptom checklist score and those with GERD were associated with greater odds for reporting combination symptoms compared with the upper abdominal pain subgroup of dyspepsia or the early satiety subgroup of dyspepsia, respectively.


CONCLUSIONS
Distinct subgroups of uninvestigated dyspepsia do exist in the general population, suggesting that separate evaluation and treatment strategies are needed.
Choung
Rok Seon
RS
Dyspepsia Center and Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Locke
G Richard
GR
Schleck
Cathy D
CD
Zinsmeister
Alan R
AR
Talley
Nicholas J
NJ
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D004415:Dyspepsia / Q000145:classification* / Q000150:complications / Q000175:diagnosis; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D014839:Vomiting / Q000209:etiology