DYSPEPSIA IN THE COMMUNITY IS LINKED TO SMOKING AND ASPIRIN USE BUT NOT TO HELICOBACTER-PYLORI INFECTION

Background: The relationship between Helicobacter pylori infection and symptoms remains controversial. We aimed to determine if an associati on exists between unexplained dyspepsia (pain or discomfort centered i n the upper part of the abdomen) and H pylori. Methods: A validated qu estionnaire was completed by 592 healthy blood donors. Helicobacter py lori serologic values (via enzyme-linked immunosorbent assay), blood g roup status, and Rh status were measured; 4.9% of subjects who had a h istory of peptic ulcer disease were excluded from the analyses. Result s: The prevalence of dyspepsia and no ulcer history was 11% (95% confi dence interval [CI], 8.6%-13.8%); 15.4% of subjects with dyspepsia had H pylori while 14.6% of subjects without dyspepsia were infected (P = .90). The mean dyspepsia impact scores (combining frequency and sever ity) in those with and without H pylori were 4.7 and 5.4, respectively (P = .20). The median H pylori optical density values in dyspepsia vs no dyspepsia were not significantly different (P = .30). Independent risk factors for dyspepsia were the use of aspirin (odds ratio [OR], 2 .2; 95% CI, 1.3-3.7) and smoking (OR, 2.1; 95% CI, 1.3-3.6) but not ag e, sex, marital status, educational level, income, or the use of alcoh ol, coffee, or nonsteroidal antiinflammatory drugs. Independent risk f actors for H pylori were increasing age (OR, 1.8 per decade; 95% CI, 1 .5-2.3), male sex (OR, 2.1; 95% CI, 1.3-3.4), and net family income (O R, 1.8; 95% CI, 1.2-3.3). Conclusion: Dyspepsia in the community is li nked to smoking and aspirin use, but not to H pylori infection.