Peptic ulcer and non-ulcer dyspepsia--a disease and a disorder

In a cross-sectional survey for coronary risk factors, 14,390 middle-aged men and women answered a questionnaire concerning life-style, diet and disease, including peptic ulcer (PU) and dyspeptic symptoms. The overall lifetime prevalence of reported PU was 5.3% in men and 2.1% in women. The prevalence of reported dyspeptic symptoms, consistent with non-ulcer dyspepsia (NUD), was 22.6% in men and 18.1% in women. Reporting of both PU and NUD was significantly associated with sex and age, NUD less marked than PU. PU and NUD differed substantially with respect to associations with psychologic, social, life-style, and dietary variables. PU was strongly associated with age, a family history of peptic ulcer, body mass index, and smoking. NUD, on the other hand, showed closest association to psychological factors and social conditions. This difference between PU and NUD might be of aetiological and therefore clinical significance, and calls for therapeutic trials in NUD patients with interventions different from the traditional peptic ulcer treatments.