Epidemiology of Functional Dyspepsia and Subgroups in the Italian General Population: An Endoscopic Study

Zagari, Rocco Maurizio; Law, Graham Richard; Fuccio, Lorenzo; Cennamo, Vincenzo; Gilthorpe, Mark S.; Forman, David; Bazzoli, Franco

doi:10.1053/j.gastro.2009.12.057

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Volume 138, Issue 4 , Pages 1302-1311, April 2010

Epidemiology of Functional Dyspepsia and Subgroups in the Italian General Population: An Endoscopic Study

Rocco Maurizio Zagari
- Department of Clinical Medicine, University of Bologna, Bologna, Italy
- Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, England
Graham Richard Law
- Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, England
Lorenzo Fuccio
- Department of Clinical Medicine, University of Bologna, Bologna, Italy
Vincenzo Cennamo
- Department of Clinical Medicine, University of Bologna, Bologna, Italy
Mark S. Gilthorpe
- Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, England
David Forman
- Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, England
Franco Bazzoli
- Department of Clinical Medicine, University of Bologna, Bologna, Italy
- Reprint requests Address requests for reprints to: Franco Bazzoli, MD, Department of Clinical Medicine, Bologna University, Policlinico Sant'Orsola, Via Massarenti n. 9, 40138 Bologna, Italy. fax: (39) 0 513 43926

Received 11 September 2009; accepted 29 December 2009. published online 13 January 2010.

Background & Aims

Population-based endoscopic studies are needed to assess the epidemiology of functional dyspepsia (FD) and the newly suggested subgroups of meal-related symptoms and epigastric pain. We evaluated the prevalence of, and risk factors for, FD in the Italian general population.

Methods

A total of 1533 inhabitants of 2 villages were invited to undergo symptom evaluation using a validated questionnaire, esophagogastroduodenoscopy, and ¹³C-urea breath test; 1033 subjects (67.4%) took part.

Results

Of the 1033 subjects, 156 (15.1%; 95% confidence interval [CI], 12.9–17.3) had dyspepsia, and of these 114 (11%; 95% CI, 9.2–12.9) had FD. Of the 114 subjects with FD, 77 (67.5%) had meal-related symptoms (postprandial fullness and/or early satiation) and 55 (48.2%) had epigastric pain. Only 18 subjects (15.8%) had both meal-related symptoms and epigastric pain; this was fewer than expected by chance alone (P < .001). Unemployment (odds ratio [OR], 5.80; 95% CI, 1.56–21.60), divorce (OR, 2.76; 95% CI, 1.10–6.91), smoking (OR, 1.74; 95% CI, 1.11–2.70), and irritable bowel syndrome (OR, 3.38; 95% CI, 1.85–6.19) were significantly associated with FD. Unemployment, divorce, and irritable bowel syndrome were associated with both meal-related symptoms and epigastric pain, while smoking was associated only with meal-related symptoms.

Conclusions

FD is present in 11% of the Italian general population. Unemployment and divorce seem to increase the risk of FD, and smoking seems to be associated with meal-related symptoms. Two distinct subgroups of FD, as suggested by Rome III, seem to exist in the general population.

Keywords: Epidemiology, Functional Dyspepsia, General Population

Abbreviations used in this paper: ¹³C-UBT, ¹³C-urea breath test, BMI, body mass index, CI, confidence interval, FD, functional dyspepsia, H pylori, Helicobacter pylori, IBS, irritable bowel syndrome, MICOL, Multicentre Italian Study on Cholelithiasis, OR, odds ratio