Dyspeptic symptoms in the community.

Dyspeptic symptoms in the community An international working party recently proposed a definition of dyspepsia as 'upper abdominal or retrosternal pain, discomfort, heartburn, nausea, vomiting, or other symptom considered to be referable to the proximal alimentary tract.' This broad definition was divided into non-ulcer dyspepsia, with symptoms lasting for more than four weeks, unrelated to exercise and for which no focal lesion or systemic disease can be found responsible, and organic dyspepsia, caused by specific lesions such as peptic ulcer, reflux oesophagitis, gastric carcinoma and cholelithiasis, which could be readily identified on routine investigation. This definition is similar to that proposed in a position paper published by the Health and Public Policy Committee of the American College of Physicians, in which the basic element of dyspepsia was said to be epigastric pain or discomfort, accompanied by fullness, burning, belching, bloating, nausea, vomiting, fatty food intolerance or difficulty completing a meal.2 The authors of this paper were confident that heartburn, defined as a hot or burning sensation located in the substernal region and often related to position, is generally distinguishable from dyspepsia. In reality this distinction may not be so easy to make, because a recent community survey of dyspeptic symptoms has shown that both upper abdominal discomfort and heartburn are frequently experienced by people with upper alimentary digestive complaints.3