Risk indicators of organic diseases in uninvestigated dyspepsia: A one-week survey in 246 Italian endoscopy units

Vincenzo Stanghellini, Marcello Anti, Gabriele Bianchi Porro, Roberto Corinaldesi, Giovanni Gasbarrini, Attilio Giacosa, Roberto Fiocca, Carlo LaVecchia, Giovanni Maconi, Eva Negri

Research output: Contribution to journalArticle

Abstract

Objective. To evaluate the predictive value of demographic and clinical features and of the results of an office-based test for Helicobacter pylori antibodies, in the presence of organic dyspepsia. Design. Over a 1-week period, 2206 consecutive patients first referred for endoscopy in 246 Italian centres were included. Methods. Demographic and clinical features, endoscopy findings, and histological diagnosis of H. pylori infection were recorded for all patients. IgG antibodies to H. pylori were determined in 2128 cases by a rapid, immunochromatographic method. Results. Endoscopic abnormalities were found in 939 patients (42.6%). Histologically assessed H. pylori infection was predictive for duodenal ulcer (odds ratio (OR), 6.79; 95% confidence interval (CI), 4.4-10.5). Being male (OR, 1.97; 95% CI, 1.7-2.3), older than 40 years (OR, 1.81; 95% CI, 1.5-2.2), a smoker (OR, 1.88; 95% CI, 1.6-2.3), and presenting nocturnal awakening (OR, 1.62; 95% CI, 1.3-2.0) were independently associated with secondary dyspepsia. Epigastric (OR, 1.50; 95% CI, 1.2-1.9) and retrosternal pain (OR, 1.39; 95% CI, 1.1-1.8) severe enough to affect the usual activities were predictive of organic diseases. The results of the Flex Sure HP test correlated poorly with histological findings. Conclusions. Male gender, older age, cigarette smoking, a family history of peptic ulcer, symptoms severe enough to induce awakening, epigastric/retrosternal pain severe enough to influence the usual activities are all independently (although weakly) associated with organic dyspepsia. H. pylori infection is strongly associated with duodenal ulcer, but the rapid test we used was not sensitive enough to achieve clinical utility. (C) 1999 Lippincott Williams and Wilkins.

Original languageEnglish
Pages (from-to)1129-1134
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume11
Issue number10
Publication statusPublished - 1999

Keywords

  • Dyspepsia
  • Endoscopy
  • Helicobacter pylori
  • Histology
  • Office-based tests

ASJC Scopus subject areas

  • Gastroenterology

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    Stanghellini, V., Anti, M., Porro, G. B., Corinaldesi, R., Gasbarrini, G., Giacosa, A., Fiocca, R., LaVecchia, C., Maconi, G., & Negri, E. (1999). Risk indicators of organic diseases in uninvestigated dyspepsia: A one-week survey in 246 Italian endoscopy units. European Journal of Gastroenterology and Hepatology, 11(10), 1129-1134.