Major life event stress and dyspepsia of unknown cause: a case control study

Stress is purported to be a major cause of non-ulcer dyspepsia, defined here as dyspepsia where peptic ulcer, oesophagitis, and cancer are excluded by endoscopy. There is a subgroup of non-ulcer dyspepsia patients who have no definite cause for their dyspepsia, provisionally termed essential dyspepsia. The aim of the present study was to determine if stress, as measured by major life events, was associated with essential dyspepsia. The frequency of life events during the year before the diagnosis of essential dyspepsia in 68 consecutive patients was compared with the frequency of these events over the same time period in 68 randomly selected age and sex-matched community controls. The mean number of events and the associated life change and distress scores were similar for both groups. Concerning individual events, patients reported more minor personal illness (p = 0.008). When events were broadly categorised, only one difference was found - more controls reported bereavements (p = 0.008). Age, sex, social class, and the duration of dyspepsia did not influence the number and nature of events. Although the study suggests that stress, as measured by major life events, is not associated with dyspepsia of unknown cause, it does not exclude the fact that other forms of stress, especially that associated with chronic difficulties, may be relevant.