Epidemiology of functional dyspepsia and subgroups in the Italian general population: an endoscopic study

Background & aims: Population-based endoscopic studies are needed to assess the epidemiology of functional dyspepsia (FD) and the newly suggested subgroups of meal-related symptoms and epigastric pain. We evaluated the prevalence of, and risk factors for, FD in the Italian general population.

Methods: A total of 1533 inhabitants of 2 villages were invited to undergo symptom evaluation using a validated questionnaire, esophagogastroduodenoscopy, and (13)C-urea breath test; 1033 subjects (67.4%) took part.

Results: Of the 1033 subjects, 156 (15.1%; 95% confidence interval [CI], 12.9-17.3) had dyspepsia, and of these 114 (11%; 95% CI, 9.2-12.9) had FD. Of the 114 subjects with FD, 77 (67.5%) had meal-related symptoms (postprandial fullness and/or early satiation) and 55 (48.2%) had epigastric pain. Only 18 subjects (15.8%) had both meal-related symptoms and epigastric pain; this was fewer than expected by chance alone (P < .001). Unemployment (odds ratio [OR], 5.80; 95% CI, 1.56-21.60), divorce (OR, 2.76; 95% CI, 1.10-6.91), smoking (OR, 1.74; 95% CI, 1.11-2.70), and irritable bowel syndrome (OR, 3.38; 95% CI, 1.85-6.19) were significantly associated with FD. Unemployment, divorce, and irritable bowel syndrome were associated with both meal-related symptoms and epigastric pain, while smoking was associated only with meal-related symptoms.

Conclusions: FD is present in 11% of the Italian general population. Unemployment and divorce seem to increase the risk of FD, and smoking seems to be associated with meal-related symptoms. Two distinct subgroups of FD, as suggested by Rome III, seem to exist in the general population.