Introduction: Uninvestigated dyspepsia is dyspepsia that has not been investigated and those present in the community are different from those in the hospital setting which are seen mostly after different self-attempts at treatment.  Considering the pattern and burden of uninvestigated dyspepsia in the rural and suburban settings with associated epidemiological factors, may stimulate the need for prevention promotion and efforts at adaptability of the available management guidelines in resource poor settings.

Materials and Methods: A population based cross sectional study conducted within a suburban town of Ekiti State, Nigeria. A total of 510 questionnaires were self-administered by randomly selected respondents. The prevalence of uninvestigated dyspepsia, most troublesome symptoms and severity of dyspepsia based on SF-LDQ were determined. Association between dyspeptic and non-dyspeptic groups with epidemiological factors was determined with Chi Square and logistic regression.

Results: The overall prevalence of uninvestigated dyspepsia in this study was found to be 68.0% (347/510). The most troublesome dyspeptic symptoms were indigestion at 22.5%, heartburn at 18.0%, nausea at 17.5%, and regurgitation at 10.0%. Multivariate analysis of significant epidemiological factors showed that younger age group, regular use of NSAIDs, regular use of much pepper and inadequate exercise were predictive of uninvestigated dyspepsia.

Conclusion: This study shows a high prevalence of uninvestigated dyspepsia, with indigestion identified as the most troublesome symptom while regurgitation is the most frequent and heartburn has the greatest impact on lifestyle. Use of NSAIDs, excessive consumption of pepper, older age, and inadequate exercise were associated with increased risk of developing uninvestigated dyspepsia.

1. Solomon OA, Solomon OO, Deji-Dada OO, Ajayi AO, Wealth CA. Management of dyspepsia in the Emergency Department of a Teaching Hospital in Southwest Nigeria: a 5-year Review, World Journal of Research and Review. 2023; 16(1):21-26. https://doi.org/10.31871/WJRR.16.1.9
2. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut. 2015;64(7):1049-57. https://doi.org/10.1136/gutjnl-2014-307843
3. Lee YJ, Adusumilli G, Kyakulaga F, Muwereza P, Kazungu R,Blackwell TS, et al. Survey on the prevalence of dyspepsia and practices of dyspepsia management in rural Eastern Uganda. Heliyon. 2019; 5(6) https://doi.org/10.1016/j.heliyon.2019.e01644
4. Holcombe C, Omotara BA, Padonu MK, Bassi AP. The prevalence of symptoms of dyspepsia in northeastern Nigeria. A random community-based survey. Trop Geogr Med. 1991;43(1-2):209-14.
5. Solomon OA, Ajayi AO. Risk factors for un-investigated dyspepsia among primary care patients in northern Nigeria. Afr Health Sci. 2013;13(4):1007-11. https://doi.org/10.4314/ahs.v13i4.21
6. Chinecherem OA, Ibiam UC, Chidiebere U, Chinedu UN. Knowledge, prevalence and risk factors of eating disorders and peptic ulcer disease among clinical students at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu. medRxiv 2024.12.01.24318266. https://doi.org/10.1101/2024.12.01.24318266
7. Ihezue CH, Oluwole FS, Onuminya JE, Okoronkwo MO. Dyspepsias among the highlanders of Nigeria: an epidemiological survey. Afr J Med Med Sci. 1996;25(1):23-9.
8. Bangamwabo JB, Chetwood JD, Dusabejambo V, Ntirenganya C, Nuki G, Nkurunziza A, et al. Prevalence and sociodemographic determinants of dyspepsia in the general population of Rwanda. BMJ Open Gastroenterol. 2020;7(1):e000387. https://doi.org/1136/bmjgast-2020-000387.
9. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion 2009; 79:196-201.
10. Kaji M, Fujiwara Y, Shiba M, Kohata Y, Yamagami H, Tanigawa T, et al. Prevalence of overlaps between GERD, FD and IBS and impact on health-related quality of life. J Gastroenterol Hepatol. 2010; (6):1151-6. https://doi.org/10.1111/j.1440-1746.2010.06249.x.
11. Mahadeva S, Yadav H, Rampal S, Goh KL. Risk factors associated with dyspepsia in a rural Asian population and its impact on quality of life. Am J Gastroenterol 2010; 105:904-912.
12. Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol 2001; 20:103-106.
13. Moayyedi P, Duffett S, Braunholtz D, Mason S, Richards ID, Dowell AC, et al. Alimentary Pharmacology and Therapeutics. The Leeds Dyspepsia Questionnaire: a valid tool for measuring the presence and severity of dyspepsia. 1998; 12(12):1257–1262. https://doi.org/doi:10.1046/j.1365-2036.1998.00404.x
14. Bitwayiki R, Orikiiriza JT, Kateera F, Bihizimana P, Karenzi B, Kyamanywa P, et al. Dyspepsia prevalence and impact on quality of life among Rwandan healthcare workers: A cross-sectional survey. S Afr Med J. 2015;105(12):1064-9. https://doi.org/7196/SAMJ.2015.v105i12.9482
15. Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001 May-Jun;20(3):103-6. PMID: 11400800
16. Jones RH, Lydeard SE, Hobbs FD, Kenkre JE, Williams EI, Jones SJ, Repper JA, Caldow JL, Dunwoodie WM, Bottomley JM. Dyspepsia in England and Scotland. Gut. 1990;31(4):401-5. https://doi.org/10.1136/gut.31.4.401
17. Ford AC, Marwaha A, Sood R, Moayyedi P. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut. 2015;64(7):1049-57. https://doi.org/10.1136/gutjnl-2014-307843.
18. Verma A, Verma D, Bansal P, Bansal A. The study of risk factors associated with dyspepsia. International Journal of Biomedical and Advance Research 2016; 7(9): 468-471. https://doi.org/10.7439/ijbar
19. Monda V, Villano I, Messina A, Valenzano A, Esposito T, Moscatelli F, et al. Exercise Modifies the Gut Microbiota with Positive Health Effects. Oxid Med Cell Longev. 2017; 2017:3831972. https://doi.org/10.1155/2017/3831972.
20. Huang I, Pranata R, Pangestu W, Kosasih FN, Raffaello WM, Yanto TA, et al. The prevalence of uninvestigated dyspepsia and the association of physical exercise with quality of life of uninvestigated dyspepsia patients in Indonesia: An internet-based survey. Indian J Gastroenterol. 2021;40(2):176-182. https://doi.org/10.1007/s12664-020-01113-z.

Olusoji Abidemi SOLOMON

Department of Family Medicine, College of Medicine, Ekiti State University, Ado Ekiti, Ekiti State