Epidemiología de la dispepsia en una comunidad del sur de España. Prevalencia de la infección por Helicobacter pylori / Epidemiology of dyspepsia in a random mediterranean population. Prevalence of Helicobacter pylori infection

OBJETIVO: la verdadera prevalencia de la dispepsia en la comunidad es poco conocida, pues la mayoría de los estudios se han realizado sobre muestras no representativas de la -población general. El objetivo fue estudiar la prevalencia de la dispepsia en una muestra aleatoria de una población general, así como sus características sociodemográficas y epidemiológicas. DISEÑO EXPERIMENTAL Y PARTICIPANTES: se realizó un estudio epidemiológico prospectivo basado en una encuesta directa y personal en una muestra de 264 sujetos, elegida al azar, entre una población del sur de España. RESULTADOS: la prevalencia de dispepsia fue del 24 por ciento, sin apreciarse relación entre ésta y diversos parámetros demográficos, hábitos tóxicos o subgrupos de dispepsia. El 49 por ciento de la población se automedicaba y el 44 por ciento acudió en busca de ayuda médica por su dispepsia. Mostraron un síndrome de intestino irritable 36 sujetos (13,6 por ciento) y 20 de ellos referían también síntomas de dispepsia (55,5 por ciento). Habían sido investigados 40 sujetos con dispepsia (80 por ciento mediante radiología con papilla de bario, 45 por ciento con ecografía y 18 por ciento con gastroscopia), obteniéndose un diagnóstico de enfermedad orgánica en el 45 por ciento de ellos. El subgrupo de dispepsia similar a reflujo gastroesofágico fue el más frecuente (60 por ciento), observándose un amplio solapamiento entre los diversos subgrupos de dispepsia. Los anti-H. Pylorí-IgG fueron positivos en el 52 por ciento, pero no hubo relación entre la infección bacteriana y la presencia de dispepsia. CONCLUSIONES: la dispepsia afecta a una cuarta parte de nuestra población, asociándose a síndrome de intestino irritable en la mitad de los casos, pero sin relación con la presencia de una infección por H. pylori (AU)

Epidemiology of dyspepsia in a random mediterranean population. Prevalence of Helicobacter pylori infection.

AIM: The prevalence of dyspepsia in the community is poorly known, because most studies have used samples that were not representative of the general population. This study was intended to determine the prevalence of dyspepsia in a random sample of the general population, and its epidemiologic and sociodemographic characteristics. METHODS: In this descriptive study we used a questionnaire administered during a personal interview to survey a random sample of 264 subjects in a Mediterranean population. RESULTS: The prevalence of dyspepsia was 24%; we found no relation between prevalence and demographic characteristics, smoking and drinking, or type of dyspepsia. Forty subjects with dyspepsia were examined and the specific diagnosis was found in 18 (45%) of them. The subgroup with reflux-like dyspepsia was the largest (60%), although there was considerable overlap between subgroups with reflux-like, ulcer-like and dysmotility-like dyspepsia. Anti-Helicobacter pylori antibodies (IgG) were found in 52% of the subjects, but bacterial infection was not related with dyspepsia. CONCLUSIONS: Up to one-fourth of the general population in the city where the subjects reside may have dyspepsia. This disorder was associated with irritable bowel syndrome in half of the cases, but was not associated with H. pylori infection.

Irritable bowel syndrome in patients with dyspepsia: a community-based study in southern Europe.

OBJECTIVES: Dyspepsia and irritable bowel syndrome (IBS) share aetiopathogenic factors, and may therefore be part of a single disorder. This study was intended to determine their prevalence in the general population, and the degree of overlap between these two digestive disorders. DESIGN: Descriptive study. METHODS: A sample of 264 subjects chosen randomly from the population census of a city in Spain, and considered representative of the general population in this city, was surveyed by questionnaire. RESULTS: The prevalence of dyspepsia was 23.9%, and that of IBS was 13.6%. Of the subjects with dyspepsia, 31.6% had IBS, and of the subjects with IBS, 55.6% reported symptoms of dyspepsia. The prevalence of IBS was higher among subjects with dyspepsia (31.7%) than among those who reported no symptoms of dyspepsia (7.9%; P < 0.05). Moreover, the prevalence of IBS was similar in three subgroups identified according to the type of dyspepsia described (ulcer-like, reflux-like or dysmotility-like). When we compared subjects with both dyspepsia and IBS and those with dyspepsia alone, we found no significant differences in clinical characteristics except for abdominal pain and fear of cancer, which were more frequent in the former. Of the entire sample, 27.7% of the subjects sought medical attention for IBS and 17% missed work because of IBS. CONCLUSION: Our findings suggest that functional dyspepsia and IBS are two manifestations of a single, more extensive digestive system disorder.

[Asymptomatic chronic intrahepatic cholestasis and multiple hypodense nodules in the liver and the spleen: manifestations of a case of sarcoidosis]. / Colestasis intrahepática crónica asintomática y múltiples nódulos hipodensos en hígado y bazo: manifestaciones de un caso de sarcoidosis.

Sarcoidosis is a systemic granulomatous disease of unknown etiology which may present multiple clinical manifestations. Liver involvement is observed among 21-79% of the cases. Nonetheless, hepatic sarcoidosis is usually asymptomatic and the finding of cholestasis is an infrequent complication. In the last few years, the presence of multiple hypodense nodules in the liver and spleen has been described in 5-15% of these patients following the application of dynamic intravenous techniques in abdominal CT scan. Although the histopathologic study of these nodules suggests that their formation is due to the coalescence of the microscopic granulomas, the cause of this aggregation remains unknown. A case of hepatic sarcoidosis presenting chronic cholestasis and whose abdominal tomographic study with intravenous contrast demonstrated the existence of hypodense lesions in the liver and spleen suggesting malignant disseminated disease is reported.

Dyspeptic symptoms and gastric emptying of solids in patients with functional dyspepsia. Role of Helicobacter pylori infection.

BACKGROUND: Our aim was to investigate the relation between dyspeptic symptoms, gastric emptying of digestible and indigestible solids, and Helicobacter pylori infection in patients with functional dyspepsia. METHODS: We used isotopic labeling and radiologic techniques to study gastric emptying of a solid meal and of 10 radiopaque indigestible solids in 50 healthy volunteers and 50 patients with functional dyspepsia. In addition, we determined the presence of seven symptoms of dyspepsia and added the score for each symptom to obtain an index of dyspepsia for each patient. RESULTS: Seventy-eight per cent of our dyspeptic patients had gastroparesis to a solid meal, and 68% to indigestible solids. We found no apparent relation between gastroparesis or H. pylori infection and dyspeptic symptoms separately or as an index of dyspepsia. Moreover, the presence of the bacteria was not related to gastroparesis to a solid meal or to indigestible solids. CONCLUSIONS: We conclude that neither symptoms of dyspepsia nor H. pylori appears to be related to gastroparesis to solids. H. pylori infection is not related to dyspeptic symptoms.

Gastroparesis of digestible and indigestible solids in patients with insulin-dependent diabetes mellitus or functional dyspepsia.

Gastric emptying of a solid meal and of 10 indigestible radiopaque solids was measured with scintigraphic and radiological techniques in 50 healthy volunteers (controls), 41 patients with insulin-dependent diabetes mellitus, and 50 patients with functional dyspepsia. Gastroparesis was found in 51% of our diabetic patients and 74% of our patients with dyspepsia. The values of Tlag, T1/2 and the percentage of isotope remaining in the stomach at 105 min were 14.9 min, 59.4 min and 25.3% in control subjects; 21.4 min, 88.1 min, and 46.9% in diabetic patients (P < 0.05 vs the control group); and 23.2 min, 114.6 min, and 58.7% in dyspeptic patients (P < 0.05 vs the control group). Whereas all healthy volunteers emptied all 10 indigestible solids in less than 4 hr, only 51% and 32% of diabetics and dyspeptics, respectively, achieved this emptying time (P < 0.01). Their respective values of T1/2 were 81 min, 212 min, and 203 min (P < 0.01 for diabetics and dyspeptics vs controls). We found no correlation between the findings for gastric emptying of digestible and indigestible solids. We conclude that gastroparesis affecting digestive and interdigestive motility is present in a high percentage of diabetics and functional dyspeptics and that conscientious evaluation of gastroparesis in both groups requires studies designed specifically to characterize each type of motility.