Publication

One-year prognosis of primary care dyspepsia: predictive value of symptom pattern, Helicobacter pylori and GP management

Quartero, A. O., Numans, ME., Post, MWM. & de Melker, RA., Jan-2002, In : European journal of gastroenterology & hepatology. 14, 1, p. 55-60 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

Background and aims Dyspepsia is a highly prevalent, heterogeneous condition with a poorly defined clinical course in family practice. We observed its clinical outcome and identified prognostic factors.

Patients We studied 583 patients presenting to their general practitioner (GP) with a new episode of dyspeptic complaints.

Methods A validated dyspepsia severity score was used to observe deterioration of dyspepsia. Furthermore, the general health status and the patient's perception of no Improvement were registered. As prognostic determinants, demographic characteristics, concomitant conditions, and management were studied. Univariate and multivariate analyses were performed.

Results A total of 518 (89%) patients completed the 1-year follow-up. Of these, 111 patients (22%, 95% CI 18% to 25%) had a negative change in their dyspepsia score after 1 year; 46 patients (9%, 95% CI 6% to 11%) noted Impairment of general health; and 122 patients (24%, 95% CI 20% to 28%) regarded complaints as not improved. Frequent dyspepsia (>1 episode/year) and a history of peptic ulcer predicted deterioration of dyspepsia, while smoking and little psychological distress predicted impairment of general health. Eradication of Helicobacter pylori reduced the chance of patient's negative judgement for especially those with frequent dyspepsia.

Conclusion One-quarter of the dyspepsia patients had an unfavourable 1-year prognosis, which was predictable because of frequent complaints and previously diagnosed ulcers. Psychological factors need to be identified, since they are related to general health improvement. The observed benefit of H. pylori eradication on perceived improvement of complaints may well be placebo effect. Eur J Gastroenterol Hepatol 14:55-60 (C) 2002 Lippincott Williams Wilkins.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalEuropean journal of gastroenterology & hepatology
Volume14
Issue number1
Publication statusPublished - Jan-2002
Externally publishedYes

    Keywords

  • cohort study, dyspepsia, general practice, Helicobacter pylori, prognosis, GENERAL-PRACTICE, NONULCER DYSPEPSIA, ENDOSCOPY, DISEASE, QUESTIONNAIRE, INFECTION, HP

ID: 3992245