Skip to main content
SpringerLink
Log in

Nonulcer Dyspepsia: A Diagnostic and Therapeutic Challenge

  • Conference paper
Book cover The Stomach

Abstract

Dyspepsia is a common complaint. When asked, about one in three to four of the population at large admits to suffering from dyspepsia [58, 66]. This high prevalence of dyspepsia is reflected in the general practitioner’s consulting room. A Danish study reports that, in 1 year, 12% of the district’s population went to see their doctor for dyspeptic complaint [30]. In Sweden, Adami et al. [1] found “gastritis” (clinically assessed) to be the fourth commonest diagnosis in general practice and the seventh commonest in outpatient clinics, accounting for 2% of all outpatient consultations, and for 31% of consultations for gastrointestinal disorders. On investigation, evidence of peptic ulcer disease may be found in only 20%–30% of dyspeptic patients, whilst in 20%–50% no definite pathology can be found to explain the symptoms [6, 15, 39, 47, 52, 53, 57].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adami H-O, Agenas I, Gustavsson S, Loof S, Nyberg A, Nyren O, Tyllstrom J (1984) The clinical diagnosis of “gastritis”. Aspects of demographic epidemiology and health care consumption based on a nationwide sample survey. Scand J Gastroenterol 19: 216–219

    PubMed  CAS  Google Scholar 

  2. Adami H-O, Bergstrom O, Nyren O et al. (1987) Is duodenal ulcer really a psychosomatic disease? A population based case control study. Scand J Gastroenterol 22: 889–896

    Article  PubMed  CAS  Google Scholar 

  3. Aune S (1969) Intragastric pressure after vagotomy. Scand J gastroenterol 4: 447–452

    Article  PubMed  CAS  Google Scholar 

  4. Azpiroz F, Malagelada J-R (1990) Perception and reflex relaxation of the stomach in response to gut distention. Gastroenterology 98: 1193–1198

    PubMed  CAS  Google Scholar 

  5. Bernersen B, Johnsen R, Straume B, Burhol PG (1992) Erosive prepyloric changes in dyspeptics and non-dyspeptics in a defined population. The Sorreisa Gastrointestinal Disorder Study. Scand J Gastroenterol 27: 233–237

    Article  PubMed  CAS  Google Scholar 

  6. Bonnevie O, Kallehauge HE, Wulff HR, Wulff MR (1971) Prognostic value of the augmented histamine test in ulcer disease and X-ray negative dyspepsia. Scand J Gastroenterol 6: 732–729

    Article  Google Scholar 

  7. Bradette M, Pare P, Douville P, Morin A (1991) Visceral perception in health and functional dyspepsia. Crossover study of gastric distention with placebo and domperidone. Dig Dis Sci 36: 52–58

    Article  PubMed  CAS  Google Scholar 

  8. Camilleri M, Malagelada J-R, Kao PC, Zinsmeister AR (1986) Gastric autonomic responses to stress in functional dyspepsia. Dig Dis Sci 31: 1169–1177

    Article  PubMed  CAS  Google Scholar 

  9. Cederberg A, Varis K, Salmi HA, Sipponen P, Harkonen M, Sarna S (1991) Young onset peptic ulcer disease and non-ulcer dyspepsia are separate entities. Scand J Gastroenterol 186: 33–44

    Article  CAS  Google Scholar 

  10. Coffin B, Azpiroz F, Malagelada J-R (1991) Elective gastric hypersensitivity and reflex hypo- reactivity in functional dyspepsia. Gastroenterology 100: A431

    Google Scholar 

  11. De Ponti F, Azpiroz F, Malagelada JR (1989) Relaxatory responses of the canine proximal stomach to esophageal and duodenal distention: importance of vagal pathways. Dig Dis Sci 34: 873–881

    Article  PubMed  Google Scholar 

  12. Desai KM, Sessa WC, Vane JR (1991) Involvement of nitric oxide in the reflex relaxation of the stomach to accommodate food or fluid. Nature 351: 477–478

    Article  PubMed  CAS  Google Scholar 

  13. Dooley CP (1991) Helicobacter pylori: review of research findings. Aliment Pharmacol Ther 5, Suppl 1: 129–143

    Article  PubMed  Google Scholar 

  14. Elta GH (1991) Helicobacter pylori in patients with non-ulcer dyspepsia. Rev Infect Dis 13, Supply 8: S696 - S699

    Article  PubMed  Google Scholar 

  15. Gear MWL, Barnes RJ (1980) Endoscopic studies of dyspepsia in a general practice. Br Med J 58: 437–443

    Google Scholar 

  16. Goh KL, Parasakthi N, Peh SC, Wong NW, Lo YL, Puthucheary SD (1991) Helicobacter pylori infection and non-ulcer dyspepsia: the effect of treatment with colloidal bismuth subcitrate. Scand J Gastroenterol 26: 1123–1131

    Article  PubMed  CAS  Google Scholar 

  17. Gregory DW, Davies GT, Evans KT, Rhodes J (1972) Natural history of patients with X-ray negative dyspepsia in general practice. Br Med J 4: 519–520

    Article  PubMed  CAS  Google Scholar 

  18. Haug TT, Svebak S, Hausken T, Wilhelmsen I, Berstad A (1992) Personality factors as predictors of stress-related antral motility, vagal activation and symptoms in functional dyspepsia patients. Scand J Gastroenterol 27, suppl 190: 106

    Google Scholar 

  19. Hausken T, Berstad A (1992) Wide gastric antrum in patients with non-ulcer dyspepsia. Effect of cisapride. Scand J Gastroenterol 27: 427–432

    Article  PubMed  CAS  Google Scholar 

  20. Hausken T, Berstad A (1992) Cisapride treatment of patients with non-ulcer dyspepsia and erosive prepyloric changes. A double-blind, placebo-controlled trial. Scand J Gastroenterol 27: 213–217

    Article  PubMed  CAS  Google Scholar 

  21. Hausken T, Berstad A (1992) Effect of glyceryl trinitrate on symptoms and antral size and motility in patients with functional dyspepsia. Scand J Gastroenterol 27, Suppl 190: 106

    Google Scholar 

  22. Hausken T, Svebak S, Wilhelmsen I, Tangen Haug T, Pettersson E, Olavsen K, Hveem K, Berstad A (1993) Low vagal tone and antral dysmotility in patients with functional dyspepsia. Psychosomatic Medicine. 55: 12–22.

    PubMed  CAS  Google Scholar 

  23. Hui WM, Shiu LP, Lam SK (1991) The perception of life events and daily stress in nonulcer dyspepsia. Am J Gastroenterol 86: 292–296

    PubMed  CAS  Google Scholar 

  24. Jian R, Ducrot F, Piedeloup C, May JY, Najean Y, Bernier JJ (1985) Measurement of gastric emptying in dyspeptic patients. Effect of a new gastrokinetic agent (cisapride). Gut 26: 352–358

    Article  PubMed  CAS  Google Scholar 

  25. Johannessen T, Fjosne U, Kleveland PM, Halvorsen T, Kristensen P, Loge I, Hafstad PE, Sandbakken P, Petersen H (1988) Cimetidine responders in non-ulcer dyspepsia. Scand J Gastroenterol 23: 327–336

    Article  PubMed  CAS  Google Scholar 

  26. Johannessen T, Petersen H, Kleveland PM, Dybdahl JH, Sandvik AK, Brenna E et al. (1990) The predictive value of history in dyspepsia. Scand J Gastroenterol 27; 689–697

    Article  Google Scholar 

  27. Karvonen A-L, Lehtola J (1984) Outcome of gastric mucosal erosions. A follow-up study of elective gastroscopic patients. Scand J Gastroenterol 19: 228–234

    PubMed  CAS  Google Scholar 

  28. Kerlin P (1989) Postprandial antral hypomotility in patients with idiopathic nausea and vomiting. Gut 30, 54–59

    Article  PubMed  CAS  Google Scholar 

  29. Krag E (1965) Pseudo-ulcer and true peptic ulcer. A clinical, radiographic and statistical follow- up study. Acta Med Scand 178: 713–728

    Article  PubMed  CAS  Google Scholar 

  30. Krag E (1982) Non-ulcer dyspepsia. Introduction: Epidemiological data. Scand J Gastroenterol 17, Suppl 79: 6–8

    CAS  Google Scholar 

  31. Labo G, Bortolotti M, Vezzadini P, Bonora G, Bersoni G (1986) Interdigestive gastroduodenal motility and serum motilin in patients with idiopathic delay in gastric emptying. Gastroenterology 90: 20–26

    PubMed  CAS  Google Scholar 

  32. Lance, P, Wastell C, Schiller KFR (1986) A controlled trial of Cimetidine for the treatment of non-ulcer dyspepsia. J Clin Gastroenterol 8: 414–418

    Article  PubMed  CAS  Google Scholar 

  33. Lehmann M, Dederding JP, Flourie B, Franchisseur C, Rambaud JC, Rian R (1991) Abnormal perception of visceral pain in response to gastric distention in chronic idiopathic dyspepsia. The irritable stomach syndrome. Dig Dis Sci 36: 1249–1254

    Article  Google Scholar 

  34. Lydeard S, Jones R (1989) Factors affecting the decision to consult with dyspepsia: comparison of consulters and non-consulters. J R Coll Gen Pract 39: 495–498

    PubMed  CAS  Google Scholar 

  35. Magnall YF, Houghton LA, Bread NW, Johnsen AG (1991) Non-ulcer dyspepsia: Pattern of emptying of fatty liquids from the proximal and distal stomach. Eur J Gastroenterol Hepatol 3, Suppl 1, 9 (abstract)

    Google Scholar 

  36. Malagelada JR, Stanghellini V (1985) Manometric evaluation of functional upper gut symptoms. Gastroenterology 88: 1223–1231

    PubMed  CAS  Google Scholar 

  37. Marshall BJ, McGechie DB, Roger PA, Glancy RJ (1985) Pyloric Campylobacter infection and gastroduodenal disease. Med J Aus 142: 439–444

    CAS  Google Scholar 

  38. Mearin F, Cucala M, Azpiroz F, Malagelada J-R (1991) The origin of symptoms on the brain- gut axis in functional dyspepsia. Gastroenterology 101: 999–1006

    PubMed  CAS  Google Scholar 

  39. Mollmann K-M, Bonnevie O, Gudmand-Hoyer E, Wulff HR (1975) A diagnostic study of patients with upper abdominal pain. Scand J Gastroenterol 10: 805–809

    PubMed  CAS  Google Scholar 

  40. Nesland Aa, Berstad A (1985) Erosive prepyloric changes in persons with and without dyspepsia. Scand J Gastroenterol 20: 222–228

    Article  PubMed  CAS  Google Scholar 

  41. Nesland Aa, Berstad A (1985) Effect of Cimetidine in patients with non-ulcer dyspepsia and erosive prepyloric changes. Scand J Gastroenterol 20: 629–635

    Article  PubMed  CAS  Google Scholar 

  42. Nesland Aa, Øktedalen O, Opstad PK, Serck-Hanssen A, Aase S, Berstad A (1989) Erosive prepyloric changes—a manifestation of stress? Scand J Gastroenterol 24: 522–528

    Article  PubMed  CAS  Google Scholar 

  43. Nyren O, Adami HO, Bergstrdm R, Gustavsson S, Loof L (1985) Psychological factors are crucial in the etiology of non-ulcer dyspepsia. A population based case-control study. In: Nyren O. Non-ulcer dyspepsia. Acta Univ Upsal 527, 1–34 (thesis)

    Google Scholar 

  44. Nyren O, Adami HO, Bergstrom R, Gustavasson S, Lööf L, Nyberg A (1986) Absence of therapeutic benefit from antacids or cimetidine in non-ulcer dypepsia. N Engl J Med 314: 339–343

    Article  PubMed  CAS  Google Scholar 

  45. Patchett S, Beattie S, Leen E, Keane C, O’Morain C (1991) Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia. BMJ 303: 1238–40

    Article  PubMed  CAS  Google Scholar 

  46. Ricci R (1987) Are dyspeptic symptoms related to distension of the gastric antrum? Dig Dis Sci 32, 924

    Google Scholar 

  47. Saunders JHB, Oliver RJ, Higson DL (1986) Dyspepsia. Incidence of non-ulcer disease in a controlled trial of ranitidine in general practice. Br med J 292: 665–668

    Article  CAS  Google Scholar 

  48. Spiro HM (1974) Visceral viewpoints. Moynihan’s disease? The diagnosis of duodenal ulcer. N Engl J Med 290: 567–569

    Article  Google Scholar 

  49. Stanghellini V, Ghidini C, Maccarini MR, Paparo GF, Corinaldesi R, Barbara L (1992) Fasting and postprandial gastrointestinal motility in ulcer and non-ulcer dyspepsia. Gut 33: 184–190

    Article  PubMed  CAS  Google Scholar 

  50. Stene-Larsen G, Weberg R, Frøyshov Larsen I, Bjørtuft Ø, Hoel B, Berstad A (1988) Relationship of overweight to hiatus hernia and reflux oesophagitis. Scand J Gastroenterol 23: 427–432

    Article  PubMed  CAS  Google Scholar 

  51. Stene-Larsen G, Nesland Aa, Berstad A (1989) Follow-up study of erosive prepyloric changes. Scand J Gastroenterol 24: 430–433

    Article  PubMed  CAS  Google Scholar 

  52. Switz DM (1976) What the gastroenterologist does all day: a survey of a state society’s practice. Gastroenterology 70: 1048–1050

    PubMed  CAS  Google Scholar 

  53. Talley NJ, Piper DW (1985) The association between non-ulcer dyspepsia and other gastrointestinal disorders. Scand J Gastroenterol 20: 896–900

    Article  PubMed  CAS  Google Scholar 

  54. Talley NJ, Piper DW (1987) A prospective study of social factors and major life stress in patients with dyspepsia of unknown cause. Scand J Gastroenterol 22, 268–272

    Article  PubMed  CAS  Google Scholar 

  55. Talley NJ, Jones M, Piper DW (1988) Psychological and childhood factors in essential dyspepsia. Scand J Gastroenterol 23, 341–346

    Article  PubMed  CAS  Google Scholar 

  56. Talley NJ, Zinsmeister AR, Schleck CD, Melton III, LJ (1992) Dyspepsia and dyspepsia subgroups: A population based study. Gastroenterology 102: 1259–1268

    PubMed  CAS  Google Scholar 

  57. Thompson WG (1984) Non-ulcer dyspepsia. Can Med Assoc J 130: 565–569

    PubMed  CAS  Google Scholar 

  58. Tibblin G (1985) Introduction to the epidemiology and dyspepsia. Scand J Gastroenterol 20, Suppl 109: 29–33

    Article  Google Scholar 

  59. Troncon LEA, Bennett RJM, Ahluwalia NK, Thompson DG (1992) Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia. Gut 33, Suppl 1, 22

    Google Scholar 

  60. Tytgat GN, Graham DY, Lee A, Marshall BJ, Dixon MF, Axon ATR (1991) Helicobacter pylori: causal agent in peptic ulcer disease? J Gastroenterol Hepatol 6: 103–140

    Article  Google Scholar 

  61. Urbain JC, Siegel J, Debie NC, Pauwels SP (1988) Effect of cisapride on gastric emptying in dyspeptic patients. Dig Dis Sci 33, 779–783

    Article  PubMed  CAS  Google Scholar 

  62. Viskum K (1977) Ulcer disease. A comparison of some clinical and genetic aspects in patients suffering from duodenal ulcer, gastric ulcer and pseudo-ulcer syndrome. Dan Med Bull 24: 213–235

    PubMed  CAS  Google Scholar 

  63. Waldron B, Cullen PT, Kumar R, Smith D, Jankowski J, Hopwood D, Sutton D, Kennedy N, Campbell FC (1991) Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study. Gut 32, 246–251

    Article  PubMed  CAS  Google Scholar 

  64. Weberg R, Berstad A (1988) Low-dose antacids and pirenzepine in the treatment of patients with non-ulcer dyspepsia and erosive prepyloric changes. A randomized, double-blind, placebo-controlled trial. Scand J Gastroenterol 23: 237–243

    Article  PubMed  CAS  Google Scholar 

  65. Wegener M, Borsch G, Schaffstein J, Schulz-Flake C, Mai U, Leverkus F (1988) Are dyspeptic symptoms in patients with Campylobacter pylori-associated type B gastritis linked to delayed gastric emptying? Am J Gastroenterol 83, 737–740

    PubMed  CAS  Google Scholar 

  66. Weir RD, Backett EM (1968) Studies of the epidemiology of peptic ulcer in a rural community: Prevalence and natural history of dyspepsia and peptic ulcer. Gut 9: 75–83

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. Berstad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Hausken
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany

    W. Domschke MD MD(hon) FACG (Chairman of the Department of Medicine B) (Chairman of the Department of Medicine B)

  2. University of Kraków, ul. Grzegórzecka 16, PL-31531, Kraków, Poland

    S. J. Konturek MD (Chairman of the Institute of Physiology) (Chairman of the Institute of Physiology)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Berstad, A., Hausken, T. (1993). Nonulcer Dyspepsia: A Diagnostic and Therapeutic Challenge. In: Domschke, W., Konturek, S.J. (eds) The Stomach. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78176-6_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78176-6_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56613-7

  • Online ISBN: 978-3-642-78176-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation