Epidemiology of dyspepsia and esophagogastroduodenoscopic findings in the era of Helicobacter pylori eradication

Figure 1 Prevalence rates of upper gastrointestinal symptoms. A: Prevalence of upper gastrointestinal symptoms, including heartburn, upper abdominal pain and bloating, and dyspepsia by 10-year age groups and in the overall population. The prevalence of upper abdominal pain declines after the age of 60 years, while bloating gradually decreases with advancing age; B: Comparison of dyspepsia prevalence between participants younger than 60 years and those aged ≥ 60 years. Dyspepsia is statistically significantly more prevalent in participants aged < 60 years than in those aged ≥ 60 years (Fisher’s exact test: ^aP < 0.001).

Figure 2 Prevalence of dyspepsia according to the Helicobacter pylori status and gastric atrophy. The prevalence of dyspepsia across the three cohorts categorized by Helicobacter pylori (H. pylori) eradication history and endoscopic evidence of atrophic gastritis is presented. Dyspepsia prevalence is 28.7% in the non-infected and post-eradication cohorts, with no marked difference. The currently infected/naturally eradicated cohort has a prevalence (25.8%) lower than that of the other two cohorts (Kruskal-Wallis test: ^aP < 0.05 and ^bP < 0.01, respectively). The “currently infected or naturally eradicated” cohort includes individuals without a self-reported H. pylori eradication history but with endoscopic gastric atrophy, representing a heterogeneous group where active H. pylori infection cannot be precisely distinguished from a few spontaneous eradications due to the absence of additional infection testing. NS: Not significant.

Figure 3 Multivariate logistic regression analysis of factors correlated with dyspepsia. This analysis revealed that the following factors were independently correlated with dyspepsia: Age < 60 years [odds ratio (OR) = 1.25; 95% confidence interval (CI): 1.15-1.35], female sex (OR = 1.81; 95%CI: 1.70-1.93), successful Helicobacter pylori eradication (OR = 1.14; 95%CI: 1.07-1.21), gastric ulcer (OR = 1.57; 95%CI: 1.01-2.44), duodenal ulcer (OR = 2.51; 95%CI: 1.20-5.26), reflux esophagitis (OR = 1.31; 95%CI: 1.16-1.49), and history of gastric surgery (OR = 1.57; 95%CI: 1.21-2.03). Conversely, no notable correlations were found for gastric or esophageal cancer. H. pylori: Helicobacter pylori; Los A: Los Angeles classification grade A reflux esophagitis; OR: Odds ratio.