Excess sick-listing in nonulcer dyspepsia

The pattern of sick leave among 88 patients with nonulcer dyspepsia (NUD) and 73 patients with duodenal/prepyloric ulcer disease (DU/PPU) was studied by means of a computerized register held by the National Health Insurance Service, which covered all instances in which patients received cash benefit due to sickness. Patients with either NUD or DU/PPU were associated with a considerably increased risk of being sick-listed. The risk of needing sick days was significantly higher in the NUD group than in the ulcer group (p less than 0.02), and the NUD patients had on an average 2.6 times as many sick days requiring compensation as the corresponding background population. The ulcer patients were absent from work mainly because of their abdominal symptoms; other reasons for sick-leave were rare. On the other hand, the sick-listing among NUD patients was due to a host of complaints, dominated not by abdominal but by musculoskeletal symptoms. Thus, it seems as if several factors other than dyspepsia contribute to the disposition towards absenteeism among NUD patients. Psychosocial factors might play an even greater role in NUD than in DU/PPU patients. The present study contradicts the concept of NUD and DU/PPU as different manifestations or stages of the same disease entity. In view of the high prevalence of NUD, the substantial amount of sickness absenteeism poses a considerable economic burden on society.