Objective-To examine the association between dyspeptic symptoms and endoscopic and histological diagnoses.Design-Cross sectional study of people with dyspepsia and controls matched for age and sex identified by questionnaire survey of all inhabitants aged 20 to 69. Endoscopy and histological examination was performed with the examiner blind to whether or not the patient had dyspepsia.Setting-Population based survey in S0rreisa, Norway.Subjects

This study, designed to overcome methodological problems inherent in earlier prevalence studies of peptic ulcer, was carried out in a municipality in northern Norway. It included the total population of 2027, aged 20-69 years, and comprised a questionnaire and search for previously diagnosed peptic ulcers in the local medical records for all subjects, and additional endoscopy of all subjects with dyspepsia and their matched healthy controls (n=619). The overall prevalence was 10*5% in men and 9'5% in women, a sex ratio close to one and a higher duodenal:gastric ratio than previously reported from this region. A substantial 1% prevalence of asymptomatic ulcers was also observed.

Objective-To determine the association between infection with Helicobacterpylori and dyspepsia.Design-Cross sectional study of dyspeptic subjects and age and sex matched controls identified by a questionnaire survey of ali inhabitants aged 20-69. (Endoscopy, histological examination, and microbiological examinations of biopsies from the gastric mucosa were performed blind.)Setting-Population based survey in S0rreisa, Norway.Subjects-All 782 dyspeptic subjects (excluding those with a previous history of peptic ulcer, gall stones or kidney stones, and coronary heart disease) and controls were offered an endoscopy, of whom 309 dyspeptic subjects and 310 controls attended.Main outcome measures-Prevalences of endoscopic and histological diagnoses and of cultures positive for H pylori.Results-A high prevalence of positive cultures, increasing with age, was found in both dyspeptic subjects (48%) and non-dyspeptic controls (36%) (p=0O004). Positive cultures in both dyspeptic subjects and controls were strongly associated with histological gastritis (70%, 95% confidence interval 65*5 to 85-3; 60%, 52-7 to 67.7, respectively) and peptic ulcer (92%, 61*5 to 99-8; 64-1, 9-4 to 99-2, respectively). Only 3% of subjects with a histologically non-inflamed gastric mucosa had this infection (dyspeptic subjects 2%, 0-2 to 7-0; controls 4%; 1-2 to 8-8).Conclusions-The relation between dyspeptic symptoms and H pylon is dubious; H pylori seems to have a pathogenetic role in gastritis and may be a contributing factor but not a cause of peptic ulcer.

Study objective -To analyse simultaneously the effect of several risk factors for peptic ulcer. Design -Cohort study where all patients with new or incident peptic ulcers in a well defined population were registered for a seven year period. The follow up started with a comprehensive health survey including a questionnaire on diet, lifestyle, psychological and social conditions, and health. Relative risks, both sex specific and separate, for gastric and duodenal ulcers were estimated from proportional hazard regression analysis. Setting -A population based survey conducted in the municipality of Troms0, northern Norway. Participants -In 1980, a total of 21 440 men and women, aged 20 to 54 years and 20 to 49 years respectively, were invited to participate. A total of 14 667 people attended and returned the questionnaire. Main results -A total of 328 people had their first peptic ulcer in the follow up period. Age, cigarette smoking, first degree relatives with peptic ulcer, and low educational level were shared risk factors for peptic ulcer in both men and women. In men, frequent upper respiratory infections increased the risk of gastric ulcer and drinking a great deal of milk increased the risk of duodenal ulcer. None of the other dietary variables, including coffee and alcohol consumption, contributed significantly to the risk. Use of analgesics was not a risk factor, and none of the psychological indicators analysed carried any significant risk.Conclusions -Age, inheritance, and cigarette smoking are all important risk factors for peptic ulcer. The increased risk associated with low educational background indicate that social strains, comprising lifestyle and diet habits, are part of the multifactorial aetiology of

No abstract