Functional Dyspepsia Is Prevalent Worldwide
Although dyspepsia is a common complaint, its definition has evolved over the past 50 years. Consensus meetings proposing standardized definitions have not resolved the controversies surrounding dyspepsia, particularly those regarding the overlap between heartburn and upper abdominal pain or discomfort. Therefore, the prevalence and natural history of functional dyspepsia remain unknown.
In the March 2004 issue of Alimentary Pharmacology and Therapeutics, Hashem B. El-Serag, MD, MPH, and Nicholas J. Talley, MD, PhD, reported the results of a systematic review of the literature on dyspepsia published between 1980 and 2002. Results from the analysis of 22 studies showed that the worldwide prevalence of uninvestigated dyspepsia ranges from 10% to 40%. When the definition of dyspepsia was limited to subjects with upper abdominal pain, irrespective of the presence of heartburn or acid regurgitation, the prevalence rate estimate was 5% to 12%.
A variable prognosis was found in the 13 studies that examined the clinical course of functional dyspepsia. An outcome of symptom improvement was reported in at least 50% of patients in 10 of the 13 studies and in at least 66.7% of patients in 6 of the 13 studies. Prognostic factors were inconsistent and, in general, poorly described. The authors concluded that, although functional dyspepsia is prevalent worldwide, its prognosis remains poorly defined.