J Med Assoc Thai 2010; 93 (3):30

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Risks of Repeated Visits for Uninvestigated Dyspepsia in Three Community Hospitals of Khon Kaen, Thailand
Premgamone A Mail, Maskasem S , Thamrongwarangoon A , Ussavaphark W

Background: Uninvestigated dyspepsia (UD) is common and only 26.4% of these are peptic ulcer disease, while 50% are
non-ulcer dyspepsia. A recent study found that nephrolithiasis with urinary tract infection may have the dyspeptic symptoms.

Objective: The authors searched for any associations between repeated UD and pyuria, hematuria and other factors.

Material and Method: A case-control study was performed. It consisted of 489 patients with repeated UD who had visited
community hospitals for at least two times per year and 489 controls sampled from the data of the subjects, free of dyspeptic
symptoms, from the multi-stage random survey for subjective health complaints in the same province. Multivariate logistic
regression models were used for case-control comparisons.

Results:
By logistic regression analysis, UD was significantly associated with problems caused by purine-rich foods (PRFs),
chronic fatigue, flank paresthesia, hematuria, myofascial pain, and pyuria. The respective adjusted odds ratios and 95%
confidence interval (CI) were: 6.67 (4.58, 9.68), 5.06 (3.46, 7.40), 3.98 (2.41, 6.60), 2.97 (2.01, 4.38), 1.91 (1.32, 2.76) and
1.58 (1.01, 2.45). The variables of age (>48), sex, dysuria, poly-arthralgia, headache and back pain were not significantly
associated with UD. The foods that aggravated UD were bamboo shoots, fermented rice noodles, beef, alcohol and insects.
The rate of pyuria and hematuria was significantly increased with the number of visits within a year [p-value (Chi-square for
trend), 0.015 and 0.032].

Conclusion:
These findings indicate that pyuria, hematuria, and purine-rich foods were associated with repeated hospital
visits for dyspepsia.

Keywords: Bamboo shoots, Purine-rich foods, Nephrolithiasis, Urinary red blood cell, Urinary white blood cell, Dyspepsia

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