Prevalence of Uninvestigated Dyspepsia 8 Years After a Large Waterborne Outbreak of Bacterial Dysentery: A Cohort Study

Background & Aims

Symptoms of dyspepsia may occur following an episode of acute gastroenteritis, but data are conflicting. We assessed prevalence of uninvestigated dyspepsia in a cohort of individuals, some of whom were exposed to bacterial dysentery in May 2000, as well as risk factors for dyspepsia in exposed individuals.

Methods

This was a cohort study conducted in the town of Walkerton, Ontario, Canada. Involved individuals were recruited into the Walkerton Health Study between 2002 and 2003 and were attending for annual assessment in 2008. Exposed individuals were subdivided into those with self-reported gastroenteritis, with acute illness unconfirmed by health records, and those with clinically confirmed gastroenteritis, with substantiation of acute illness by health record review. Presence of dyspepsia at 8 years, according to a broad definition (any symptom referable to the upper gastrointestinal tract), and the Rome II criteria, was compared between exposed and nonexposed individuals.

Results

Of 2597 subjects eligible, 1088 (41.9%) provided data for analysis, and 706 (64.9%) had reported acute gastroenteritis. Multivariate odd ratios for dyspepsia at 8 years in exposed individuals using a broad definition and the Rome II definition were 2.09 (95% confidence interval: 1.58–2.78) and 2.30 (95% confidence interval: 1.63–3.26), respectively. Prevalence of dyspepsia was higher in females; smokers; those with premorbid irritable bowel syndrome, anxiety, or depression; and those reporting >7 days of diarrhea or abdominal cramps during the acute illness.

Conclusions

Symptoms of dyspepsia 8 years after an outbreak of acute gastroenteritis were significantly more prevalent in exposed compared with nonexposed individuals.

Keywords: Dyspepsia, Prevalence, Gastroenteritis

Abbreviations used in this paper: BSG, British Society of Gastroenterology, CI, confidence interval, GI, gastrointestinal, IBS, irritable bowel syndrome, NSAIDs, non-steroidal anti-inflammatory drugs, OR, odds ratio, S-FLDQ, short-form Leeds dyspepsia questionnaire, WHS, Walkerton Health Study