Dyspeptic symptoms in the general population: a factor and cluster analysis of symptom groupings

Abstract

Both dyspeptic and gastro-oesophageal reflux-like symptoms are frequent in the general population, but their degree of overlap is unknown. In severe functional dyspepsia (FD), symptoms are organized in factors associated with pathophysiological mechanisms. The aims of this study were: (i) to assess the prevalence of dyspeptic symptoms with and without overlapping reflux symptoms in the general population and their impact on daily life and on healthcare utilization; and (ii) to compare symptom groupings in the general population to FD patients. A total of 2025 subjects, representative of the Belgian general population, were used in this study. The subjects were submitted to a questionnaire with validated questions on their dyspeptic and reflux symptoms and with evaluators of impact on daily life and use of healthcare resources. Significant dyspeptic symptoms were found in 417 (20.6%). Overlapping reflux symptoms were present in 141 (33.8%). In this group, symptoms were more frequent and more severe. Dyspeptic symptoms induced weight loss (12.7%) and absenteeism (12.4%), affected daily life (61.2%) and generated use of healthcare resources, such as medical consultations (61.4%) and medication (70.9%). Factor analysis revealed a three-component structure with factor 1 including fullness, bloating and early satiety, factor 2 including nausea and vomiting and factor 3 including discomfort, pain, belching and reflux. If forced in a four-factor model, the analysis separates belching as independent factor. Dyspeptic symptoms are frequent in the general population, with overlapping reflux symptoms and increased symptom burden in about a third.

Prevalence of dyspeptic symptoms and heartburn of adults in Belo Horizonte, Brazil

“…Ge nerally, the prevalence of FD is lower in the East than the West (27,28) , and greater when the Rome I or II criteria is adopted (especially due to greater symptom periods, which can possibly increase the preva lence) (36) . Regardless of the data obtained, it is necessary to point out a limitation in these results, that cannot be generalized for the entire population with dyspeptic symptoms and heartburn, because a representative sample has not been used.…”

Functional Dyspepsia

“…1 These two syndromes were proposed because as many as 80% of persons with dyspepsia report that their symptoms are aggravated by the ingestion of a meal. 22 The definitions were also based on factor analysis that showed the grouping of dyspeptic symptoms into three or four clusters, 23,24 with the epigastric pain syndrome and the postprandial distress syndrome appearing consistently in several different studies. Subsequent community-based cross-sectional surveys, which showed good separation between these two subgroups, support this approach.…”

Somatic Complaints Are Significantly Associated with Chronic Uninvestigated Dyspepsia and Its Symptoms: A Large Cross-sectional Population Based Study

“…These findings are naturally expected because of the large overlap between gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and FD, and often they coexist in the same patient. There is great overlap between FD and GERDlike symptoms 51 ; and this overlap is greatest between nonerosive and functional heartburn and FD in which the clinical spectrum that extends from FD to nonerosive reflux disease may be present in up to 70% of GERD disease in the community. 52 This association might indicate a common pathophysiologic mechanism.…”