Dyspepsia in general practice: history and symptoms in relation to Helicobacter pylori serum antibodies

This study was designed to explore the relationships between serologic Helicobacter pylori positivity and demographic, behavioural, and symptomatologic factors in patients consulting for dyspeptic symptoms in general practice.

H. pylori enzyme-linked immunosorbent assay results and checklist data were collected by general practitioners at three community health centers in southern Sweden from consecutive patients aged 18-65 years with upper abdominal pain or discomfort (dyspepsia).

Of the 130 available patients with dyspepsia, 127 agreed to participate, 45 (mean age, 41.2 years) being classified as H. pylori-positive and 82 (mean age, 33.5 years) as H. pylori-negative. Manual workers were diagnosed as H. pylori-positive significantly more often than were non-manual workers (p < 0.05). Of those patients examined earlier by gastroscopy or roentgenography, H. pylori-positives reported stomach or duodenal ulcer significantly more often than did H. pylori-negatives (p < 0.01). H. pylori-positives reported stomach/duodenal ulcer in their parents/siblings to a significantly greater extent than did H. pylori-negatives (45.2% versus 10.1%, p < 0.001). H. pylori-negatives reported stress-generated symptoms significantly more often than did H. pylori-positives (82.9% versus 61.5%, p < 0.01). Hierarchical regression analyses showed that, when age and sex were controlled for, the ability of each of these measures to predict the serologic results remained significant.

Higher levels of H. pylori antibodies in dyspeptic patients appear to be associated with a relatively low self-perception of stress, with manual work, with being older, and with the occurrence, both in the patients themselves and in their close relatives, of stomach/duodenal ulcer.