Aetiology of dyspepsia in unselected patients

Evidence Summaries

Level of Evidence = C
An organic cause for dyspepsia appears to be found in 45% of unselected patients in primary care.

Upper gastrointestinal endoscopy, upper abdominal ultrasound, a test for lactose intolerance, and basic laboratory screening were performed on 400 consecutive dyspeptic patients from general practice in Finland 1 . Oesophagitis was the cause of symptoms in 15%, symptomatic gastro-oesophageal reflux without oesophagitis in 12%, duodenal ulcer in 9%, gastric ulcer in 4%, erosive duodenitis in 2%, lactose intolerance in 9%, gallstone disease in 2% and malignancy in 2%. One hundred and thirty-five patients had functional dyspepsia with subgroups of ulcer-like dyspepsia (22%), dysmotility-like (28%), and nonspecific (50%). Irritable bowel syndrome was diagnosed in 9% of the patients. Functional disorders, when symptomatic gastro-oesophageal reflux was included, were diagnosed in 55%.


1. Heikkinen M, Pikkarainen P, Takala J, Räsänen H, Julkunen R. Etiology of dyspepsia: four hundred unselected consecutive patients in general practice. Scand J Gastroenterol 1995 Jun;30(6):519-23.  [PMID:7569757]

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