The intensity and variability of symptoms in dyspepsia

Scand J Prim Health Care. 1993 Mar;11(1):50-5. doi: 10.3109/02813439308994902.


During the waiting time for upper gastrointestinal endoscopy 165 patients with dyspepsia completed a questionnaire and a diary for daily measurements of the symptoms pain, heartburn, and global complaints. 23 patients (14%) had peptic ulcer disease (PUD), 18 oesophagitis (11%), and the rest were labelled nonulcer dyspepsia (NUD). NUD was further subdivided into ulcer-like, reflux-like, dysmotility, and essential NUD by means of predefined symptom profiles. 39 (24%) patients were on H2 receptor antagonist treatment. In general, the intensity of the daily symptoms was rather low, and except for a higher rating of heartburn in oesophagitis, there were no significant differences between PUD, oesophagitis, and NUD--treated or untreated. NUD patients with reflux-like dyspepsia had significantly more heartburn than the group with essential NUD; otherwise there were no differences between the subgroups of NUD. The individual daily ratings for abdominal pain, heartburn, and global symptoms varied by an average standard deviation of 64%, 97% and 47% of the mean values, respectively, and were independent of treatment or diagnoses. There was an approximately 40% probability that two successive days had different levels of symptoms. Only 10% of the patients showed stable symptoms, and the patients were completely symptom-free for 20% of the observation period. Symptoms in dyspepsia patients disclosed low intensity and high variability in this study. Such factors may be important sources of bias in clinical trials.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dyspepsia* / etiology
  • Dyspepsia* / physiopathology
  • Endoscopy, Gastrointestinal
  • Esophagitis, Peptic / complications
  • Esophagitis, Peptic / diagnosis
  • Esophagitis, Peptic / therapy
  • Female
  • Heartburn / etiology
  • Humans
  • Male
  • Middle Aged
  • Norway
  • Peptic Ulcer / complications
  • Peptic Ulcer / diagnosis
  • Peptic Ulcer / therapy
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors