Dyspepsia in general practice: incidence, risk factors, comorbidity and mortality

BACKGROUND: Many individuals consulting their GP with upper abdominal symptoms are initially classified as having dyspepsia. Few studies have described the incidence of dyspepsia or the comorbidities, risk factors or prognosis associated with this diagnosis. METHODS: We used the UK General Practice Research Database to find patients with a new diagnosis of dyspepsia in 1996 (n = 6,913) and a control cohort (n = 11,036). We determined the incidence of dyspepsia, potential risk factors and comorbidity, and the risk of new onset morbidity in the year following the index date. RESULTS: The incidence of dyspepsia was 15.3 per 1,000 person-years. An increased probability of a dyspepsia diagnosis was associated with chest pain [odds ratio (OR): 2.4], general pain (OR: 1.8), sleep disorders (OR: 1.5), angina (OR: 1.5), osteoarthritis/rheumatoid arthritis (OR: 1.4) and smoking (OR: 1.2). There was only a borderline association with obesity (OR: 1.1). Patients with dyspepsia had an increased likelihood of a diagnosis of irritable bowel syndrome (IBS) (OR: 264), gastroesophageal reflux disease (GERD) (OR: 62.8) or peptic ulcer disease (PUD) (OR: 27.2) during the following year. CONCLUSIONS: The commonest diagnosis to emerge after an initial consultation for dyspepsia was IBS, followed by GERD and PUD.