US prevalence of upper gastrointestinal symptoms: a systematic literature review

To quantify the prevalence of dyspeptic and gastroesophageal symptoms and peptic ulcer disease (PUD) in the United States and to identify factors affecting their prevalence.

Systematic search of MEDLINE and Web of Science through November 2010.

We identified studies of US patients and evaluated a general (not disease-specific) adult sample that reported the prevalence of 1 or more upper gastrointestinal (GI) outcomes of interest, including dyspeptic symptoms, gastroesophageal symptoms, dyspeptic and/or gastroesophageal symptoms, or PUD. Proportions of individuals in each study reporting each symptom were pooled to derive separate prevalence estimates. Qualitative synthesis of data depicting multivariate relationships between covariates and upper GI outcomes was undertaken.

A total of 36 citations representing 24 studies were included: 9 studies reporting dyspeptic symptoms (n = 14,181), 14 reporting gastroesophageal symptoms (n = 58,701), 5 reporting dyspeptic and/or gastroesophageal symptoms (n = 103,175), and 7 reporting PUD prevalence (n = 269,299). The pooled prevalences of dyspeptic, gastroesophageal, and dyspeptic and/or gastroesophageal symptoms were 16.3% (95% confidence interval [CI] 9.1%-25.1%), 24.2% (95% CI 18.2%-30.5%), and 35.2% (95% CI 14.9%-58.9%). The pooled prevalence for studies asking for shorter-term PUD recall was 3.3% (95% CI 2.2%-4.6%), with lifetime PUD prevalence estimated at 13.8% (95% CI 10.7%-17.0%). The influence of covariates evaluated as part of multivariate analyses was often inconsistent.

It appears that upper GI symptoms and disorders are common in US inhabitants. We identified patient- and study-level factors that should be considered when assessing upper GI symptom prevalence and conducting future research.