Prevalences of endoscopic and histological findings in subjects with and without dyspepsia.

OBJECTIVE--To examine the association between dyspeptic symptoms and endoscopicand histologicaldiagnoses. DESIGN--Cross sectional study of people with dyspepsia and controls matched for age and sex identified by questionnaire survey of all inhabitants aged 20 to 69. Endoscopyand histologicalexamination was performed with the examiner blind to whether or not the patient had dyspepsia. SETTING--Population based survey in Sorreisa, Norway. SUBJECTS--All people with dyspepsia and age and sex matched people without dyspepsia were offered endoscopy. A total of 309 people with dyspepsia and 310 without dyspepsia underwent endoscopy, giving 273 matched pairs. MAIN OUTCOME MEASURES--Prevalences of endoscopicand histologicaldiagnoses made according to internationally accepted standards. RESULTS--In all, 1802 of 2027 (88.9%) people returned the questionnaire. Of the 163 subjects who refused endoscopy, 114 were controls. Of five endoscopicand four histologicaldiagnoses only peptic ulcerdisease, endoscopicduodenitis, and active chronic gastritiswere diagnosed significantly more often in people with dyspepsia. In all, 30% to 50% of the diagnoses of mucosal inflammation and peptic ulcerdisease were made among subjects without dyspepsia, and only 10% of both those with and those without dyspepsia had normal endoscopicfindings. CONCLUSIONS--The diagnostic findings, with possible exceptions of peptic ulcerdisease and endoscopicduodenitis, showed no association of clinical value with dyspeptic symptoms. The small number of "normal" endoscopicfindings in both those with and those without dyspepsia challenge well accepted endoscopicand histologicaldiagnostic criteria with relation to the upper gastrointestinal tract.