Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1991 March 30; 302(6779): 749–752.
PMCID: PMC1669538

Prevalences of endoscopic and histological findings in subjects with and without dyspepsia.


OBJECTIVE--To examine the association between dyspeptic symptoms and endoscopic and histological diagnoses. DESIGN--Cross sectional study of people with dyspepsia and controls matched for age and sex identified by questionnaire survey of all inhabitants aged 20 to 69. Endoscopy and histological examination was performed with the examiner blind to whether or not the patient had dyspepsia. SETTING--Population based survey in Sørreisa, Norway. SUBJECTS--All people with dyspepsia and age and sex matched people without dyspepsia were offered endoscopy. A total of 309 people with dyspepsia and 310 without dyspepsia underwent endoscopy, giving 273 matched pairs. MAIN OUTCOME MEASURES--Prevalences of endoscopic and histological diagnoses made according to internationally accepted standards. RESULTS--In all, 1802 of 2027 (88.9%) people returned the questionnaire. Of the 163 subjects who refused endoscopy, 114 were controls. Of five endoscopic and four histological diagnoses only peptic ulcer disease, endoscopic duodenitis, and active chronic gastritis were diagnosed significantly more often in people with dyspepsia. In all, 30% to 50% of the diagnoses of mucosal inflammation and peptic ulcer disease were made among subjects without dyspepsia, and only 10% of both those with and those without dyspepsia had normal endoscopic findings. CONCLUSIONS--The diagnostic findings, with possible exceptions of peptic ulcer disease and endoscopic duodenitis, showed no association of clinical value with dyspeptic symptoms. The small number of "normal" endoscopic findings in both those with and those without dyspepsia challenge well accepted endoscopic and histological diagnostic criteria with relation to the upper gastrointestinal tract.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (862K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thomson WO, Joffe SN, Robertson AG, Lee FD, Imrie CW, Blumgart LH. Is duodenitis a dyspeptic myth? Lancet. 1977 Jun 4;1(8023):1197–1198. [PubMed]
  • Cheli R. Symptoms in chronic non-specific duodenitis. Scand J Gastroenterol Suppl. 1982;79:84–87. [PubMed]
  • Joffe SN. Relevance of duodenitis to non-ulcer dyspepsia and peptic ulceration. Scand J Gastroenterol Suppl. 1982;79:88–97. [PubMed]
  • DeLuca VA, Jr, Winnan GG, Sheahan DG, Sanders FJ, Jr, Greenlaw R, Marignani P, Gorelick FS, Bhalotra R, Goldblatt RS. Is gastroduodenitis part of the spectrum of peptic ulcer disease? J Clin Gastroenterol. 1981;3(Suppl 2):17–22. [PubMed]
  • Talley NJ, Phillips SF. Non-ulcer dyspepsia: potential causes and pathophysiology. Ann Intern Med. 1988 Jun;108(6):865–879. [PubMed]
  • Guslandi M. Focus on duodenitis. Dig Dis. 1986;4(4):231–239. [PubMed]
  • Kreuning J, Bosman FT, Kuiper G, Wal AM, Lindeman J. Gastric and duodenal mucosa in 'healthy' individuals. An endoscopic and histopathological study of 50 volunteers. J Clin Pathol. 1978 Jan;31(1):69–77. [PMC free article] [PubMed]
  • Akdamar K, Ertan A, Agrawal NM, McMahon FG, Ryan J. Upper gastrointestinal endoscopy in normal asymptomatic volunteers. Gastrointest Endosc. 1986 Apr;32(2):78–80. [PubMed]
  • Management of dyspepsia: report of a working party. Lancet. 1988 Mar 12;1(8585):576–579. [PubMed]
  • Barbara L, Camilleri M, Corinaldesi R, Crean GP, Heading RC, Johnson AG, Malagelada JR, Stanghellini V, Wienbeck M. Definition and investigation of dyspepsia. Consensus of an international ad hoc working party. Dig Dis Sci. 1989 Aug;34(8):1272–1276. [PubMed]
  • Siurala M, Varis K, Kekki M. New aspects on epidemiology, genetics, and dynamics of chronic gastritis. Front Gastrointest Res. 1980;6:148–166. [PubMed]
  • Villako K, Ihamäki T, Tamm A, Tammur R. Upper abdominal complaints and gastritis. Ann Clin Res. 1984;16(4):192–194. [PubMed]
  • Whitehead R, Truelove SC, Gear MW. The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol. 1972 Jan;25(1):1–11. [PMC free article] [PubMed]
  • Whitehead R, Roca M, Meikle DD, Skinner J, Truelove SC. The histological classification of duodenitis in fibreoptic biopsy specimens. Digestion. 1975;13(3):129–136. [PubMed]
  • Bernersen B, Johnsen R, Straume B, Burhol PG, Jenssen TG, Stakkevold PA. Towards a true prevalence of peptic ulcer: the Sørreisa gastrointestinal disorder study. Gut. 1990 Sep;31(9):989–992. [PMC free article] [PubMed]
  • Johnsson F, Joelsson B, Gudmundsson K, Greiff L. Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease. Scand J Gastroenterol. 1987 Aug;22(6):714–718. [PubMed]
  • Myren J, Serck-Hanssen A. The gastroscopic diagnosis of gastritis with particular reference to mucosal reddening and mucus covering. Scand J Gastroenterol. 1974;9(5):457–462. [PubMed]
  • Spiro HM. Visceral viewpoints. Moynihan's disease? The diagnosis of duodenal ulcer. N Engl J Med. 1974 Sep 12;291(11):567–569. [PubMed]
  • Greenlaw R, Sheahan DG, DeLuca V, Miller D, Myerson D, Myerson P. Gastroduodenitis. A broader concept of peptic ulcer disease. Dig Dis Sci. 1980 Sep;25(9):660–672. [PubMed]
  • Sircus W. Duodenitis: a clinical, endoscopic and histopathologic study. Q J Med. 1985 Sep;56(221):593–600. [PubMed]
  • Danielsson A, Ek B, Nyhlin H, Steen L. The relationship between active peptic ulcer, endoscopic duodenitis and symptomatic state after treatment with cimetidine. Ann Clin Res. 1980 Feb;12(1):4–12. [PubMed]
  • Earlam RJ, Amerigo J, Kakavoulis T, Pollock DJ. Histological appearances of oesophagus, antrum and duodenum and their correlation with symptoms in patients with a duodenal ulcer. Gut. 1985 Jan;26(1):95–100. [PMC free article] [PubMed]
  • Cheli R, Giacosa A. Duodenal ulcer and chronic gastritis. Endoscopy. 1986 Jul;18(4):125–126. [PubMed]
  • Villako K, Tamm A, Savisaar E, Ruttas M. Prevalence of antral and fundic gastritis in a randomly selected group of an Estonian rural population. Scand J Gastroenterol. 1976;11(8):817–822. [PubMed]
  • Mackinnon M, Willing RL, Whitehead R. Cimetidine in the management of symptomatic patients with duodenitis: a double-blind controlled trial. Dig Dis Sci. 1982 Mar;27(3):217–219. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group