Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh.
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Clin Transl Gastroenterol. 2021 Apr 16;12(4):e00334. doi: 10.14309/ctg.0000000000000334.
INTRODUCTION: Functional dyspepsia (FD), although commoner than organic dyspepsia (OD) in-hospital studies, community data, particularly from rural areas, are lacking. We performed a rural community study in Bangladesh with the primary aims to evaluate (i) the prevalence of uninvestigated dyspepsia (UD), FD, and OD and (ii) the risk factors for UD. METHODS: This house-to-house survey was performed using a translated-validated enhanced Asian Rome III questionnaire and endoscopy with Helicobacter pylori tests, including genotyping. RESULTS: Of 3,351/3,559 responders ([94.15%], age 40.41 ± 16.05 years, female 1924 [57.4%]), 547 (16.3%) had UD (female 346 [18%] vs male 201 [14%]; P = 0.002); 201 (6%), 88 (2.6%), and 258 (7.7%) had postprandial distress (PDS), epigastric pain syndromes (EPS) and PDS-EPS overlap, respectively. On multivariate analysis, age >50 years (adjusted odds ratio [AOR] 1.34 [1.07-1.68]), female sex (AOR 1.42 [1.17-1.74]), being married (AOR 1.57 [1.21-2.07]), lower family income (AOR 1.79 [1.43-2.26]), nonsteroidal anti-inflammatory drug use (AOR 7.05 [2.11-23.55]), previous acute gastroenteritis (AOR 5.42 [1.83-16]), and psychological distress (AOR 5.02 [2.87-8.76]) were risk factors for UD. Of 346/547 (63.25%) undergoing endoscopy, 232 (67.05%) and 114 (32.95%) had FD and OD (peptic ulcers [PU] 99 [28.61%] and erosive esophagitis 13 [3.76%]). About 53% of FD subjects had EPS-PDS overlap, 32% had PDS, and only 15% had EPS. H. pylori was detected in 266/342 (78%) dyspeptics (FD 173/230 [75.2%], vs OD 92/114 [82.1%], P = 0.169). DISCUSSION: Sixteen percent, 11% and 5% of rural Bangladeshi Asian adults had UD, FD, and PU, respectively. One-third of UD subjects had OD, mostly PU.JOURNAL/cltg/04.03/01720094-202104000-00016/inline-graphic1/v/2021-04-15T161418Z/r/image-tiff.
简介：功能性消化不良（FD）虽然在住院研究中比器质性消化不良（OD）更为常见，但社区数据，特别是农村地区的数据却很缺乏。我们在孟加拉国的一个农村社区进行了一项研究，主要目的是评估（i）未经调查的消化不良（UD）、FD 和 OD 的患病率，以及（ii）UD 的风险因素。
方法：这项挨家挨户的调查使用了经过翻译验证的增强型亚洲罗马 III 问卷和内窥镜检查，包括幽门螺杆菌检测和基因分型。
结果：在 3351/3559 名应答者（[94.15%]，年龄 40.41±16.05 岁，女性 1924[57.4%]）中，有 547 人（16.3%）患有 UD（女性 346[18%] vs 男性 201[14%]；P=0.002）；201（6%）、88（2.6%）和 258（7.7%）人患有餐后不适（PDS）、上腹痛综合征（EPS）和 PDS-EPS 重叠。多变量分析显示，年龄>50 岁（调整后的优势比[OR]1.34[1.07-1.68]）、女性（OR 1.42[1.17-1.74]）、已婚（OR 1.57[1.21-2.07]）、较低的家庭收入（OR 1.79[1.43-2.26]）、非甾体抗炎药使用（OR 7.05[2.11-23.55]）、既往急性胃肠炎（OR 5.42[1.83-16]）和心理困扰（OR 5.02[2.87-8.76]）是 UD 的风险因素。在 547 名接受内镜检查的患者中，有 346 人（63.25%）进行了内镜检查，其中 232 人（67.05%）和 114 人（32.95%）患有 FD 和 OD（消化性溃疡[PU]99 例[28.61%]和糜烂性食管炎 13 例[3.76%]）。约 53%的 FD 患者存在 EPS-PDS 重叠，32%存在 PDS，只有 15%存在 EPS。在 342 名消化不良患者中，266 人（78%）检测到幽门螺杆菌（FD 患者中 173/230[75.2%]，OD 患者中 92/114[82.1%]，P=0.169）。
讨论：16%、11%和 5%的孟加拉国农村成年亚洲人分别患有 UD、FD 和 PU。三分之一的 UD 患者患有 OD，主要是 PU。
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