title: Risks of repeated visits for uninvestigated dyspepsia in three community hospitals of Khon Kaen, Thailand.
abstract: BACKGROUND
  Uninvestigated dyspepsia (UD) is common and only 26.4% of these are peptic ulcer disease, while 50% are non-ulcer dyspepsia. A recent study found that nephrolithiasis with urinary tract infection may have the dyspeptic symptoms.
  
  
  OBJECTIVE
  The authors searched for any associations between repeated UD and pyuria, hematuria and other factors.
  
  
  METHODS
  A case-control study was performed. It consisted of 489 patients with repeated UD who had visited community hospitals for at least two times per year and 489 controls sampled from the data of the subjects, free of dyspeptic symptoms, from the multi-stage random survey for subjective health complaints in the same province. Multivariate logistic regression models were used for case-control comparisons.
  
  
  RESULTS
  By logistic regression analysis, UD was significantly associated with problems caused by purine-rich foods (PRFs), chronic fatigue, flank paresthesia, hematuria, myofascial pain, and pyuria. The respective adjusted odds ratios and 95% confidence interval (CI) were: 6.67 (4.58, 9.68), 5.06 (3.46, 7.40), 3.98 (2.41, 6.60), 2.97 (2.01, 4.38), 1.91 (1.32, 2.76) and 1.58 (1.01, 2.45). The variables of age (> 48), sex, dysuria, poly-arthralgia, headache and back pain were not significantly associated with UD. The foods that aggravated UD were bamboo shoots, fermented rice noodles, beef alcohol and insects. The rate of pyuria and hematuria was significantly increased with the number of visits within a year [p-value (Chi-square for trend), 0.015 and 0.032].
  
  
  CONCLUSIONS
  These findings indicate that pyuria, hematuria, and purine-rich foods were associated with repeated hospital visits for dyspepsia.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. amorn_p@kku.ac.th
authors.forename: Amorn
authors.initials: A
authors.lastname: Premgamone
authors.forename: Srinoi
authors.initials: S
authors.lastname: Maskasem
authors.forename: Apisit
authors.initials: A
authors.lastname: Thamrongwarangoon
authors.forename: Wichai
authors.initials: W
authors.lastname: Ussavaphark
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004415:Dyspepsia / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000453:epidemiology; D006417:Hematuria / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D006764:Hospitals, Community; D006801:Humans; D007669:Kidney Calculi; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000000981:diagnostic imaging*; D016017:Odds Ratio; D015995:Prevalence; D011776:Pyuria / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D014463:Ultrasonography