Digestive Diseases and Sciences

, Volume 39, Issue 5, pp 1090–1098 | Cite as

Dyspepsia in healthy blood donors

Pattern of symptoms and association withHelicobacter pylori
  • Gerald Holtmann
  • Harald Goebell
  • Marianne Holtmann
  • Nicholas J. Talley
Article

Abstract

WhetherHelicobacter pylori is causally linked to dyspepsia remains controversial. The aims of this study were to assess in healthy blood donors the prevalence of dyspepsia and dyspepsia subgroups, determine ifH. pylori is associated with different categories of dyspeptic symptoms, and evaluate the association between dyspepsia and nicotine, alcohol, and analgesic use. Consecutive blood donors (N=180) who had no clinical evidence of organic disease were included. Abdominal symptoms were measured by means of a standardized questionnaire that has been previously validated. Subjects with dyspepsia (defined as pain localized to the upper abdomen) were further subdivided into those with ulcer-like, dysmotility-like, reflux-like, or nonspecific dyspepsia. A total of 65 subjects reported abdominal pain or discomfort during the prior 12 months [36.1%, 95% confidence interval (CI) 29.1–43.1]; 44 subjects (24.4%, 95% CI 18.2–30.7) had dyspepsia. Dysmotility-like, reflux-like, and ulcer-like symptoms were reported by 19.4% (95% CI 13.7–25.2), 17.2% (95% CI 11.7–22.7), and 16.7% (95% CI 11.2–22.1) of subjects with dyspepsia, respectively. Fifty-seven subjects (31.7%, 95% CI 24.9–38.5) wereH. pylori positive; 26% of subjects withH. pylori and 24% withoutH. pylori had dyspepsia (P>0.50). The seroprevalence ofH. pylori was also similar among the different categories of dyspepsia. We conclude that infection withH. pylori is not associated with abdominal complaints in otherwise healthy subjects.

Key words

aspirin functional dyspepsia Helicobacter pylori irritable bowel syndrome 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tibblin G: Introduction to the epidemiology of dyspepsia. Scand J Gastroenterol Suppl 109:29–33, 1985PubMedGoogle Scholar
  2. 2.
    Jones RH, Lydeard S: Prevalence of symptoms of dyspepsia in the community. Br Med J 298:30–32, 1989Google Scholar
  3. 3.
    Thompson WG, Heaton KW: Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288, 1980PubMedGoogle Scholar
  4. 4.
    Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ: Dyspepsia and dyspepsia subgroups: A population-based study. Gastroenterology 102:1259–1268, 1992PubMedGoogle Scholar
  5. 5.
    Talley NJ, Phillips SF: Non-ulcer dyspepsia: Potential causes and pathophysiology. Ann Intern Med 108:865–879, 1988PubMedGoogle Scholar
  6. 6.
    Holtmann G, Goebell H: Ursachen der funktionellen Dyspepsie. Dtsch Med Wochenschr 117:1029–1034, 1992PubMedGoogle Scholar
  7. 7.
    Talley NJ: Chronic (non-specific) gastritis. Dig Dis Sci 347:61–75, 1989Google Scholar
  8. 8.
    Morris A, Nicholson G: Ingestion of campylobacter pyloridis causing gastritis and raised fasting pH. Am J Gastroenterol 82:192–199, 1987PubMedGoogle Scholar
  9. 9.
    Blaser MJ: Hypotheses on the pathogeneses and natural history ofHelicobacter pylori-induced inflammation. Gastroenterology 102:720–727, 1992PubMedGoogle Scholar
  10. 10.
    Dooley CP, Cohen H, Fitzgibbons P, Bauer M, Appleman MD, Perez-Perez GJ, Blaser MJ: Prevalence ofHelicobacter pylori and histologic gastritis in asymptomatic persons. N Engl J Med 321:1562–1566, 1989PubMedGoogle Scholar
  11. 11.
    Blaser MJ: Gastric Campylobacter-like organisms, gastritis, and peptic ulcer disease. Gastroenterology 93:371–383, 1987PubMedGoogle Scholar
  12. 12.
    Andersen LP, Elsborg L, Justesen T:Campylobacter pylori in peptic ulcer disease. III. Symptoms and paraclinical and epidemiologic findings. Scand J Gastroenterol 23:347–350, 1988PubMedGoogle Scholar
  13. 13.
    Börsch G, Schmidt G, Wegener M, Sandmann M, Adamek R, Leverkus F, Reitemeyer E:Campylobacter pylori: Prospective analysis of clinical and histological factors associated with colonization of the upper gastrointestinal tract. Eur J Clin Invest 18:133–138, 1988PubMedGoogle Scholar
  14. 14.
    Collins JS, Knill-Jones RP, Sloan JM, Watt PCH, Hamilton PW, Crean GP, Love AHG: Comparison of symptoms between non-ulcer dyspepsia patients positive and negative forC. pylori using a single bias computer system for history taking. Klin Wochenschr 67(suppl 18):11–12, 1989PubMedGoogle Scholar
  15. 15.
    Guerre J, Berthe Y, Chaussade S, Merite F, Gaudric M, Tulliez M, Deslignieres S, Zone A: HasCampylobacter pylori gastritis a specific clinical symptomatology. Klin Wochenschr 67(suppl 18):25–26, 1989Google Scholar
  16. 16.
    Loffeld RJ, Potters HV, Arends JW, Stobberingh E, Flendrig JA, van Spreeuwel JP:Campylobacter associated gastritis in patients with non-ulcer dyspepsia. J Clin Pathol 41:85–88, 1988PubMedGoogle Scholar
  17. 17.
    Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1:1311–1315, 1984PubMedGoogle Scholar
  18. 18.
    Rathbone BJ, Wyatt J, Heatley RV: Symptomatology inC. pylori positive and negative nonulcer dyspepsia. Gut 29:A1473, 1988Google Scholar
  19. 19.
    Rokkas T, Pursey C, Uzoechina E, Dorrington L, Simmons NA, Filipe MI, Sladen GE:Campylobacter pylori and non-ulcer dyspepsia. Am J Gastroenterol 82:1149–1152, 1987PubMedGoogle Scholar
  20. 20.
    Sobala GM, Dixon MF, Axon ATR:H. pylori is not associated with a distinct dyspeptic syndrome. Gut 30:A733, 1989Google Scholar
  21. 21.
    Landini MP, Varoli O, Tucci A, Paparo GF, Corinaldesi R, Zoccoli G, Lalli AA, La Placa M: Antibodies toCampylobacter pylori in patients with idiopathic dyspepsia. Microbiologica 12:181–188, 1989PubMedGoogle Scholar
  22. 22.
    Collins JS, Knill Jones RP, Sloan JM, Hamilton PW, Watt PC, Crean GP, Love AH: A comparison of symptoms between non-ulcer dyspepsia patients positive and negative forHelicobacter pylori. Ulster Med J 60:21–27, 1991PubMedGoogle Scholar
  23. 23.
    Goh KL, Parasakthi N, Peh SC, Wong NW, Lo YL, Puthucheary SD:Helicobacter pylori infection and non-ulcer dyspepsia: The effect of treatment with colloidal bismuth subcitrate. Scand J Gastroenterol 26:1123–1131, 1991PubMedGoogle Scholar
  24. 24.
    Strauss RM, Wang TC, Kelsey PB, Campton CC, Ferraro MT, Perez-Perez G, Blaser MJ: Association ofHelicobacter pylori infection with dyspeptic symptoms in patients under-going gastroduodenoscopy. Am J Med 89:464–469, 1990PubMedGoogle Scholar
  25. 25.
    Talley NJ, Phillips SF, Bruce B, Twomey CK, Zinsmeister AR, Melton LJ III: Relation among personality and symptoms on nonulcer dyspepsia and the irritable bowel syndrome. Gastroenterology 99:327–333, 1990PubMedGoogle Scholar
  26. 26.
    Whitehead WE, Bosmajian L, Zorderman AB, Costa PT, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome. Comparison of community and medical clinic samples. Gastroenterology 95:709–714, 1988PubMedGoogle Scholar
  27. 27.
    Sitas F, Forman D, Yarnell JWG, Burr ML, Elwood PC, Pedley S, Marks KJ:Helicobacter pylori rates in relation to age and social class in a population of Welsh men. Gut 32:25–28, 1991PubMedGoogle Scholar
  28. 28.
    Colin-Jones DG, Bloom B, Bodemar G, Crean G, Freston J, Gigler R, Malagelada J, Nyrén O, Petersen H, Piper D: Management of dyspepsia: report of a working party. Lancet 1:576–579, 1988PubMedGoogle Scholar
  29. 29.
    Talley NJ, Colin-Jones D, Koch KL, Koch M, Nyrén O, Stanghellini V: Functional dyspepsia: A classification with guidelines for diagnosis and management. Gastroenterol Int 4:145–160, 1991Google Scholar
  30. 30.
    Petersen WL:Helicobacter pylori and peptic ulcer disease. N Engl J Med 324:1043–1048, 1991PubMedGoogle Scholar
  31. 31.
    Blaser MJ, Duncan DJ: Human serum antibody response toCampylobacter jejuni infection as measured in an enzyme linked immunoabsorbent assay. Infect Immun 33:292–298, 1984Google Scholar
  32. 32.
    Talley NJ, Newell DG, Ormand JE, Carpenter HA, Wilson WR, Zinsmeister AR, Perez-Perez GI, Blaser MJ: Serodiagnosis ofHelicobacter pylori: Comparison of enzyme-linked immunosorbent assay. J Clin Microbiol 29:1635–1639, 1991PubMedGoogle Scholar
  33. 33.
    Talley NJ, Phillips SF, Melton J, Wiltgen C, Zinsmeister AR: A patient questionnaire to identify bowel disease. Ann Intern Med 111:671–674, 1989PubMedGoogle Scholar
  34. 34.
    Koran LM: The reliability of clinical methods, data and judgments. N Engl J Med 293:642–646, 1975PubMedGoogle Scholar
  35. 35.
    Drossman DA, Thompson WG, Talley NJ, Funch-Jensen P, Janssens J, Whitehead WE: Identification of subgroups of functional gastrointestinal disorders. Gastroenterology 3:159–172, 1990Google Scholar
  36. 36.
    Talley NJ, Piper DW: Comparison of the clinical features and illness behaviour of patients presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. Aust NZ J Med 16:352–359, 1986Google Scholar
  37. 37.
    Fleiss JL: Statistical Methods for Rates and Proportions. New York, Wiley, 1981, pp 29–30Google Scholar
  38. 38.
    Gardner M, Altman DG: Calculating confidence intervals for proportions and their differences.In Statistics with Confidence—Confidence Intervals and Statistical Guidelines. Gardner M, Altman DG (eds). London, 1991, pp 28–33Google Scholar
  39. 39.
    Atkinson AC: A note on the generalized information criterion for choice of a model. Biomet 67:413–418, 1980Google Scholar
  40. 40.
    SAS Institute Inc. SAS/STAT User's Guide, Release 6.03. Cary, North Carolina, SAS Institute, 1988Google Scholar
  41. 41.
    Banke L: Ulcumygdommers epidemiologi. Kobenhavn, F.A.D.L.'s Forlag, 1975Google Scholar
  42. 42.
    Hollnagel H, Norrelund N, Larsen S: Marve-tarmsymptomer blandt 40-arige i Glostrup: En epidemiologisk undersogelse. Ugeskr Laeg 1982;144:267–273PubMedGoogle Scholar
  43. 43.
    Johnsen R, Straume B, Forde OH: Peptic ulcer and non-ulcer dyspepsia—a disease and a disorder. Scand J Prim Health Care 6:239–243, 1988PubMedGoogle Scholar
  44. 44.
    Harrison JD, Morris DL: Dyspepsia in coalminers and the general population: A comparative study. Br J Ind Med 46:428–429, 1989PubMedGoogle Scholar
  45. 45.
    Holcombe C, Omotara BA, Padonu MK, Bassi AP: The prevalence of symptoms of dyspepsia in north eastern Nigeria. A random community based survey. Trop Geogr Med 43:209–214, 1991PubMedGoogle Scholar
  46. 46.
    Ahmed N, Malur PR, Sankapal MN, Nagalotimath SJ: Prevalence ofCampylobacter pylori in non-ulcerative dyspepsia. Indian J Pathol Microbiol 34:247–252, 1991PubMedGoogle Scholar
  47. 47.
    Metcalf R, Youngs GR: Prevalence of symptoms of dyspepsia. BMJ 298:526–527, 1989PubMedGoogle Scholar
  48. 48.
    Jones R, Lydeard S: Prevalence of symptoms of dyspepsia in the community. BMJ 298:30–32, 1989PubMedGoogle Scholar
  49. 49.
    Weir RD, Backett EM: Studies of the epidemiology of peptic ulcer in a rural community: Prevalence and natural history of dyspepsia and peptic ulcer. Gut 9:75–83, 1968PubMedGoogle Scholar
  50. 50.
    Bernersen B, Johnsen R, Bostad L, Straume B, Sommer AI, Burhol PG: IsHelicobacter pylori the cause of dyspepsia? BMJ 304:1276–1279, 1992PubMedGoogle Scholar
  51. 51.
    Richter JE: Dyspepsia: Organic causes and differential characteristics from functional dyspepsia. Scand J Gastroenterol Suppl 182:11–16, 1991PubMedGoogle Scholar
  52. 52.
    Klauser AG, Voderholzer WA, Knesewitsch PA, Schindelbeck NE, Müller-Lissner SA: What is behind dyspepsia. Gastroenterology 100:A458, 1991Google Scholar
  53. 53.
    Blum AL, Armstrong D, Damman H, Fischer M, Greiner L, Haase W, Hogeboom-Verdegal A, Liszkay M, Stolte M, Sulser H, Simon B, Talicomp Study Group: The effect ofHelicobacter pylori on the healing and relapse of duodenal ulcer. Gastroenterology 98:A22, 1990Google Scholar
  54. 54.
    Shallcross TMJ, Rathbone BJ, Heatley RV:Campylobacter pylori and non-ulcer dyspepsia.In Campylobacter pylori and Gastroduodenal Disease. Rathbone RJ, Heatly RV (eds). Oxford, Blackwell Scientific, 1989, pp 155–166Google Scholar
  55. 55.
    Pettross CW, Appleman MD, Cohen H, Valenzuela JE, Chandrasoma P, Laine LA: Prevalence ofCampylobacter pylori and association with antral mucosal histology in subjects with and without gastrointestinal symptoms. Dig Dis Sci 33:649–653, 1988PubMedGoogle Scholar
  56. 56.
    Rauws EA, Langenberg W, Houthoff HJ, Zanen HC, Tytgat GN:Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology 94:33–40, 1988PubMedGoogle Scholar
  57. 57.
    Lambert JR, Dunn K, Borromeo M, Korman MG, Hansky J:Campylobacter pylori-a role in non-ulcer dyspepsia? Scand J Gastroenterol Suppl 160:7–13, 1989PubMedGoogle Scholar
  58. 58.
    Glupczynski Y, Burette A, Labbe M, Deprez C, De Reuck M, Deltenre M:Campylobacter pylori-associated gastritis: A double-blind placebo-controlled trial with amoxycillin. Am J Gastroenterol 83:365–372, 1988PubMedGoogle Scholar
  59. 59.
    Talley NJ: Drug treatment of functional dyspepsia. Scand J Gastroenterol Suppl 182:47–60, 1991PubMedGoogle Scholar
  60. 60.
    Vaira D, Holton J, Ainley C, Falzon M, Osborn J, D'Anna L, Romanos A, Chandrakumaran K, McNeil I: Double blind trial of colloidal bismuth subcitrate versus placebo inHelicobacter pylori positive patients with non-ulcer dyspepsia. Ital J Gastroenterol 24:400–404, 1992PubMedGoogle Scholar
  61. 61.
    Rokkas T, Pursey C, Uzoechina E, Dorrington L, Simmons NA, Filipe MI, Sladen GE: Non-ulcer dyspepsia and short term De-Nol therapy: A placebo controlled trial with particular reference to the role ofCampylobacter pylori. Gut 29:1386–1391, 1988PubMedGoogle Scholar
  62. 62.
    Dill S, Payne-James JJ, Misiewicz JJ, Grimble GK, McSwiggan D, Pathak K, Wood AJ, Scrimgeous CM, Rennie MJ: Evaluation of the13C-urea breath test in the detection ofHelicobacter pylori and in monitoring the effect of tripotassium dicitrobismuthate in non ulcer dyspepsia. Gut 31:1237–1241, 1990PubMedGoogle Scholar
  63. 63.
    McNulty CA, Gearty JC, Crump B, Davis M, Donovan IA, Melikian V, Lister DM, Wise R:Campylobacter pyloridis and associated gastritis: investigator blind, placebo controlled trial of bismuth salicylate and erythromycin ethylsuccinate. Br Med J (Clin Res Ed) 293:645–649, 1986Google Scholar
  64. 64.
    Patchett S, Beattie S, Leen E, Keane C, O'Morain C: EradicatingHelicobacter pylori and symptoms of non-ulcer dyspepsia. BMJ 303:1238–1240, 1991PubMedGoogle Scholar
  65. 65.
    Steering Committee of the Physicians' Health Study Group: Final report on the aspirin component of the ongoing physicians' health study. N Engl J Med 321:129–135, 1989Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Gerald Holtmann
    • 3
    • 1
    • 2
  • Harald Goebell
    • 3
    • 1
    • 2
  • Marianne Holtmann
    • 3
    • 1
    • 2
  • Nicholas J. Talley
    • 3
    • 1
    • 2
  1. 1.Department of Transfusion MedicineUniversity of EssenGermany
  2. 2.University of SydneySydneyAustralia
  3. 3.Department of Internal Medicine, Division of GastroenterologyUniversity of EssenEssenGermany

Personalised recommendations