Abstract
A subgroup of patients with nonulcer dyspepsia (NUD) have no definite cause for their dyspepsia, termed essential dyspepsia.The aim of the present study was to determine if environmental factors are associated with essential dyspepsia. The patterns of ingestion of analgesic drugs (aspirin, acetaminophen, dextropropoxyphene), nonaspirin, nonsteroidal antiinflammatory drugs, alcohol, coffee, tea, and smoking in 113 essential dyspepsia patients were compared with 113 randomly selected community controls matched for age, sex, and social grade. Associations were studied in two six-month periods, before diagnosis in all patients and before the onset of NUD in those patients with a short history of dyspepsia. It was found that acetaminophen ingestion was associated with essential dyspepsia, and this association was present both before the onset of the dyspepsia (OR 3.1, 95% CI 1.3– 7.1) and before diagnosis (OR 1.8, 95% CI 1.2– 2.6). None of the other environmental factors were associated with essential dyspepsia.
Similar content being viewed by others
References
Tibblin G: Introduction to the epidemiology of dyspepsia. Scand J Gastroenterol 20(Suppl 109):29–33, 1985
Krag E: Other causes of dyspepsia. Scand J Gastroenterol 17(Suppl 79):32–34, 1982
Crean GP, Card WI, Beattie AD, Holden RJ, James WB, Knill-Jones RP, Lucas RW, Spiegelhalter B: Ulcer-like dyspepsia. Scand J Gastroenterol 17(Suppl 79):9–15, 1982
Talley NJ, Piper DW: The association between non-ulcer dyspepsia and other gastrointestinal disorders. Scand J Gastroenterol 20:896–900, 1985
Connell AM, Hilton C, Irvine G, Lennard Jones JE, Misiewicz JJ: Variation of bowel habit in two population samples. Br Med J 2:1095–1099, 1965
Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of irritable bowel. Br Med J 2:653–654, 1978
Beck IT: Why, when and how to investigate gastroesophageal reflux disease. J Clin Gastroenterol 4:468–473, 1982
Rogers TF: Interviews by telephone and in person: Quality of responses and field performance. Public Opinion Q 40:51–65, 1976
Sudman S, Bradburn NM: Asking Questions: A Practical Guide to Questionnaire Design. San Francisco, Jossey-Bass, 1983
Talley NJ, McNeil D, Hayden A, Colreavy C, Piper DW: Prognosis of chronic unexplained dyspepsia. A prospective study of potential predictor variables in patients with endoscopically diagnosed non-ulcer dyspepsia. Gastroenterology 92:1060–1066, 1987
Bonnevie O: Outcome of non-ulcer dyspepsia. Scand J Gastroenterol 17(Suppl 79):135–138, 1982
Congalton AA: Status and Prestige in Australia. Melbourne, Cheshire Publishing Co., 1969
Breslow NE, Day NE: Statistical Methods in Cancer Research. Vol 1, The Analysis of Case-Control Studies. Lyon International Agency for Research on Cancer. 1980, pp 253–268
Lilienfeld AM: Foundations of Epidemiology. New York, Oxford University Press, 1976, p 181
Whittemore AS: Estimating attributable risk from case-control studies. Am J Epidemiol 117:76–85, 1983
Larsen PS, Haag HB, Silvette H (eds): Tobacco. Experimental and Clinical Studies. A Comprehensive Account of the World Literature. Baltimore, Williams and Wilkins, 1961, p 634
Dodds WJ, Hogan WJ, Helm JF, Dent J: Pathogenesis of reflux esophagitis. Gastroenterology 81:376–394, 1981
Paulus HE, Furst DE: Aspirin and antiinflammatory drugs.In Arthritis and Allied Conditions, 9th ed. DJ McCarthy (ed). Philadelphia, Lea and Febiger, 1979 pp 33–54
Buchanan WW: Clinical features of rheumatoid arthritis.In Copeman's Textbook of Rheumatic Diseases, 5th ed. JT Scott (ed). Edinburgh, E and S Livingstone, 1978, pp 318–364
Carson Dick W, de Culaer K: Non-steroidal antirheumatic drugs.In Textbook of Rheumatology. WN Kelley, ED Harris, S Ruddy, CB Sledge (eds). Philadelphia, W.B. Saunders, 1981, pp 768–784
Lewis HD, Davis JW, Archibald DJ, Steinke WE, Smitherman TC, Doherty JE, Schnap HW, Le Winter MM, Linares E, Pouget JM, Sabharwal SC, Chester L, de Mots H: Projected effects of aspirin against acute myocardial infarction and death in men with unstable angina. N Engl J Med 309:396–403, 1983
Aspirin Myocardial Infarction Study Research Group of the National Heart, Lung and Blood Institute: A randomized control trial of aspirin in persons recovered from myocardial infarction. JAMA 243:661–669, 1980
Persantine—Aspirin Reinfarction Trial Group. Circulation 62:449–461, 1980
Diamond H, Alexander S, Kezell W, Lussier A, Odore D, Tompkins R: A multicenter double-blind crossover comparison study of naproxen and aspirin in patients with rheumatoid arthritis. Scand J Rheumatol 2(Suppl):171–175, 1973
Bowers DE, Dyer HR, Fosdick WM, Kellow KE, Rosenberg AL, Sussman P, Vancil ME: Naproxen in rheumatoid arthritis. A controlled trial. Ann Inst Med 83:470–475, 1975
Parish P: Medicines: A Guide for Everybody, 2nd ed. New York, Penguin Books, 1979, pp 83–84
Cohen S: Pathogenesis of coffee-induced gastrointestinal symptoms. N Engl J Med 303:122–124, 1980
Shirlow MJ, Mathers CD: A study of caffeine consumption and symptoms: Indigestion, palpitations, tremor, headache and insomnia. Int J Epidemiol 14:239–248, 1985
Dennish GW, Castell DO: Inhibitory effect of smoking on the lower esophageal sphincter. N Engl J Med 284:1136–1137, 1971
Thomas FB, Steinbaugh JT, Fromkes JJ, Mekhjian HS, Caldwell JH: Inhibitory effect of coffee on lower esophageal sphincter pressure. Gastroenterology 79:1262–1266, 1980
Salmon PR, Fedail SS, Wurzner HP, Read AE: Effect of coffee on the lower esophageal sphincter function. Digestion 21:69–73, 1981
Cohen S, Booth GH: Gastric acid secretion and lower esophageal sphincter pressure in response to coffee and caffeine. N Engl J Med 293:897–899, 1975
Dennish GW, Castell DO: Caffeine in the lower esophageal sphincter. Am J Dig Dis 17:993–996, 1972
Turnberg LA: Coffee in the gastrointestinal tract. Gastroenterology 75:529–530, 1978 (editorial)
Ivey KJ, Silvoso GR, Krause WJ: Effect of paracetamol on gastric mucosa. Br Med J 1:1586–1588, 1978
Hoftiezer JW, O'Laughlin JC, Ivey KJ: Effects of 24 hours of aspirin, Bufferin, paracetamol and placebo on normal human gastroduodenal mucosa. Gut 23:692–697, 1982
McIntosh JH, Fung CS, Berry G, Piper DW: Smoking, non-steroidal antiinflammatory drugs and acetaminophen in gastric ulcer: A study of association of the effects of previous diagnosis on the exposure pattern. Am J Epidemiol (in press)
Sackett DL: Bias in analytic research. J Chron Dis 32:51–63, 1979
Talley NJ, Piper DW: Comparison of the clinical features and illness behaviour of patient presenting with dyspepsia of unknown cause (essential dyspepsia) and organic disease. Aust NZ J Med 16:352–359, 1986
Hill AB: Environment and disease: Association or causation. Proc R Soc Med 58:295–300, 1965
Evans AS: Reviews and commentary. Causation and disease: A chronological journey. Am J Epidemiol 108:249–258, 1978
Feldstein AR: Clinical biostatistics XLVII. Scientific standards versus statistical associations and biologic logic in analysis of causation. Clin Pharmacol Ther 25:481–492, 1979
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Talley, N.J., McNeil, D. & Piper, D.W. Environmental factors and chronic unexplained dyspepsia. Digest Dis Sci 33, 641–648 (1988). https://doi.org/10.1007/BF01540424
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01540424