Non-ulcer dyspepsia in the long-term perspective.

OBJECTIVE

To study the natural history of non-ulcer dyspepsia.

DESIGN

Retrospective study on consecutive cases of non-ulcer dyspepsia diagnosed in 1980 and 1981. The long-term course was ascertained from medical records and from answers to a questionnaire completed by the patients at 10-year follow-up.

SETTING

Out-patients at the endoscopy unit of a county hospital.

PATIENTS: The diagnosis was based on typical symptoms of dyspepsia, a normal index endoscopy and a lack of evidence of organic disease related to the symptoms during the subsequent 12-month period. Two hundred and seventy-one patients were entered into the study. Of the 195 who received a questionnaire at 10-year follow-up, 165 (85%) responded.

RESULTS

The median age at inclusion was 51 years (25-75 percentiles 38-65 years), and 130 men and 141 women were included in the study. The cumulative death rate after 10 years was 18%, a value no greater than that in the general population: 8% had died of cardiovascular disease, 1.5% of gastrointestinal cancer and 3% of other malignancies. One patient had died of a perforated gastric ulcer. At 10-year follow-up, a further three patients had developed peptic ulcers (expected number 4.2), 64% had experienced dyspeptic symptoms during the preceding 12 months and 41% had been taking analgesics during the previous week. Of the symptoms listed by the patients, 30% were typical of irritable bowel syndrome.

CONCLUSION

Non-organic dyspepsia seems to be a chronic disease in most patients. The course is benign and unrelated to peptic ulcer disease.