Risk factors for dyspepsia in a general population: non-steroidal anti-inflammatory drugs, cigarette smoking and unemployment are more important than Helicobacter pylori infection

Scand J Gastroenterol. 2006 Feb;41(2):149-54. doi: 10.1080/00365520510024070.


Objective: Dyspepsia, a common condition in the community, affects quality of life and imposes costs on both the individual and the community. Several factors including Helicobacter pylori, acetylic salicylic acid (ASA)/non-steroidal anti-inflammatory drugs (NSAIDs) use, low-dose ASA use, alcohol consumption, cigarette smoking and social status might be responsible.

Material and methods: A cross-sectional study from the inclusion (intervention group) of a general population study evaluating rates of dyspepsia after H. pylori screening and eradication was carried out. A total of 10,007 individuals aged 40-64 years received questionnaires and an invitation to take part in H. pylori screening. Information on dyspepsia (the gastrointestinal symptom rating scale (GSRS) and "most bothersome symptom"), use of ASA/NSAIDs, use of low-dose ASA, lifestyle factors and level of education and employment status was obtained from the questionnaire. Dyspepsia was defined as a score of =2 in the GSRS dimension abdominal pain syndrome (aps), allowing for a maximum of one light problem score in any of the 3 items in the dimension to be overlooked.

Results: In all, 5749/10,007 individuals participated in the study; 24.9% reported dyspepsia. In a multiple logistic regression analysis H. pylori infection was found to be a risk factor for dyspepsia, odds ratio (OR) 1.21 (CI; 1.03-1.42). However, the highest ORs for dyspepsia were: for daily use of ASA/NSAIDs 2.33 (CI; 1.72-3.15), unemployment 2.18 (CI; 2.86-2.56) and cigarette smoking =20 g/day 1.55 (CI; 1.29-1.86).

Conclusions: H. pylori infection is a significant risk factor for dyspepsia although of less importance than ASA/NSAIDs use, unemployment and heavy smoking.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Cross-Sectional Studies
  • Dyspepsia / epidemiology
  • Dyspepsia / etiology*
  • Female
  • Follow-Up Studies
  • Helicobacter Infections / complications*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance*
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Unemployment*


  • Anti-Inflammatory Agents, Non-Steroidal