Dietary and Lifestyle Factors Associated with Dyspepsia among Pre-clinical Medical Students in Ajman, United Arab Emirates

Main Article Content

Noorallah Jaber
Marwa Oudah
Amer Kowatli
Jabir Jibril
Inbisat Baig
Elsheba Mathew
Aji Gopakumar
Jayakumary Muttappallymyalil

Abstract

Introduction: Dyspepsia is a common gastrointestinal diseases worldwide with a prevalence ranging from 7 to 40%. Dyspepsia, more commonly known as heartburn or indigestion, is defined as one or more of the following symptoms: postprandial fullness, early satiation (the inability to finish a normal size meal), or epigastric pain or burning for at least 3 months in the past year. Dyspepsia has been studied extensively, but little is known of factors associated with dyspepsia among medical students.

Objectives: The purpose of this study was to analyze the prevalence of dyspepsia and to evaluate the association between lifestyle and dietary factors associated with dyspepsia among pre-clinical medical students in Ajman, United Arab Emirates.

Methods: A cross-sectional survey study was conducted among pre-clinical medical students at Gulf Medical University, Ajman and collected basic demographic data, dyspepsia prevalence, dietary factors, and lifestyle factors. Data was analyzed using Microsoft Excel and SPSS software. Descriptive statistics were used to summarize the participant characteristics. Chi-square tests were used to test the association between dietary and lifestyle factors and dyspepsia. Logistic regression was used to measure the association of predictors (dietary and lifestyle factors) on the odds of having dyspepsia, independently. Multinomial logistic regression was used to examine the full association of predictors on the odds of having dyspepsia.

Results: The resulting sample was 176 pre-clinical medical students, with a mean age of 20.67 ± 2.57 years. A total of 77 (43.8%) respondents reported having dyspepsia while 99 (56.2%) did not. There was a significant association between smoking and dyspepsia (p<0.05), as well as a marginally significant association between inadequate sleep and dyspepsia (p<0.10). There was no significant association with alcohol or analgesic use on dyspesia. Dietary habits showed no association with dyspepsia.

Conclusion: Dyspepsia was reported by 43.8% of the repondents. These findings emphasize the importance of improving lifestyle and dietary factors associated with dyspepsia and raising awareness of reducing risk factors associated with dyspepsia. Further studies are needed on dyspepsia in a larger cohort of students in order to fully understand the complexity of this problem and be able to generalize the findings to other cohorts.

Article Details

How to Cite
Jaber, N., Oudah, M., Kowatli, A., Jibril, J., Baig, I., Mathew, E., Gopakumar, A., & Muttappallymyalil, J. (2016). Dietary and Lifestyle Factors Associated with Dyspepsia among Pre-clinical Medical Students in Ajman, United Arab Emirates. Central Asian Journal of Global Health, 5(1). https://doi.org/10.5195/cajgh.2016.192
Section
Research
Author Biographies

Marwa Oudah, Gulf Medical University, Ajman

MBBS student of GMU.

Amer Kowatli, Gulf Medical University, Ajman

MBBS student of GMU.

Jabir Jibril, Gulf Medical University, Ajman

MBBS student of GMU

Inbisat Baig, Gulf Medical University, Ajman

MBBS student of GMU.

Elsheba Mathew, Department of Community Medicine, Gulf Medical University, Ajman

Faculty, Dept. of Community Medicine.

Aji Gopakumar, Statistical Support Facility, Gulf Medical University, Ajman

Statistical Support Facility, CABRI.

Jayakumary Muttappallymyalil, Department of Community Medicine, Gulf Medical University, Ajman

Faculty, Dept. of Community Medicine.

References

Baron JH, Watson F, Sonnenberg A. Three centuries of stomach symptoms in Scotland. Aliment Pharmacol Ther. 2006;24(5):821-829.

Hare E. The history of 'nervous disorders' from 1600 to 1840, and a comparison with modern views. Br J Psychiatry. 1991;159:37-45.

Chey WD. Accurate diagnosis of Helicobacter pylori. 14C-urea breath test. Gastroenterol Clin North Am. 2000;29(4):895-902.

Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130(5):1466-1479.

Harmon RC, Peura DA. Evaluation and management of dyspepsia. Therap. Adv. Gastroenterol. 2010;3(2):87-98.

Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: A global perspective. World J Gastroenterol. 2006;12(17):2661-2666.

Caro JM, Ortiz SP, Melo CL. Dyspepsia and reflux disease in adolescents. Rev Col Gastroenterol. 2008;23(1):46-56.

Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol. 1992;136(2):165-177.

Paré P. Systematic approach toward the clinical diagnosis of functional dyspepsia. Can J Gastroenterol. 1999;13(8):647-654.

Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102(4 Pt 1):1259-1268.

Talley NJ, Fett SL, Zinsmeister AR, Melton LJ. Gastrointestinal tract symptoms and self-reported abuse: A population-based study. Gastroenterology. 1994;107(4):1040-1049.

Agréus L, Talley NJ, Svärdsudd K, Tibblin G, Jones MP. Identifying dyspepsia and irritable bowel syndrome: the value of pain or discomfort, and bowel habit descriptors. Scand J Gastroenterol. 2000;35(2):142-151.

Bernersen B, Johnsen R, Straume B. Non-ulcer dyspepsia and peptic ulcer: The distribution in a population and their relation to risk factors. Gut. 1996;38(6):822-825.

Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms. Am J Gastroenterol. 1998;93(10):1816-1822.

Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in the general population in Mumbai. Indian J Gastroenterol. 2001;20(3):103-106.

Kay L, Jørgensen T. Epidemiology of upper dyspepsia in a random population. Prevalence, incidence, natural history, and risk factors. Scand J Gastroenterol. 1994;29(1):2-6.

Caballero-Plasencia AM, Sofos-Kontoyannis S, Valenzuela-Barranco M, Martín-Ruiz JL, Casado-Caballero FJ, López-Mañas JG. Irritable bowel syndrome in patients with dyspepsia: a community-based study in southern Europe. Eur J Gastroenterol Hepatol. 1999;11(5):517-522.

Shaib Y, El-Seraq HB. The prevalence and risk factors of functional dyspepsia in a multiethnic population in the United States. Am J Gastroenterol. 2004;99(1):2210-2216.

Jones RH, Lydeard SE, Hobbs FD, et al. Dyspepsia in England and Scotland. Gut. 1990;31(4):401-405.

Jones R, Lydeard S. Prevalence of symptoms of dyspepsia in the community. BMJ. 1989;298(6665):30-32.

Penston JG, Pounder RE. A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther. 1996;10(1):83-89.

Moayyedi P, Forman D, Braunholtz D, et al. The proportion of upper gastrointestinal symptoms in the community associated with Helicobacter pylori, lifestyle factors, and nonsteroidal anti-inflammatory drugs. Leeds HELP Study Group. Am J Gastroenterol. 2000;95(6):1448-1455.

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):23-29.

Talley NJ, Colin-Jones D, Koch KL, Koch M, Nyren O, Stanghellini V. Functional dyspepsia: A classification with guidelines for diagnosis and management. Gastroenterology. 1991;88(5 pt 1):1223-1231.

Holtmann G, Talley NJ. Functional dyspepsia. Current treatment recommendations. Drugs. 1993;45(6):918-930.

Armstrong D. Helicobacter pylori infection and dyspepsia. Scand J Gastroenterol Suppl. 1996;215:38-47.

Castillo EJ, Camilleri M, Locke GR, et al. A community-based, controlled study of the epidemiology and pathophysiology of dyspepsia. Clin Gastroenterol Hepatol. 2004;2(11):985-996.

Abahussain EA, Hasan FA, Nicholls PJ. Dyspepsia and Helicobacter pylori infection: Analysis of 200 Kuwaiti patients referred for endoscopy. Ann Saudi Med. 1998;18(6):502-505.

Marsden K. What doctors don't tell you: Ulcers & indigestion - developing good gut sense. 1988; http://www.healthy.net/Health/Article/ULCERS_INDIGESTION/3357/4. Accessed December 10, 2013.

Ganasegeran K, Al-Dubai SA, Qureshi AM, Al-abed AA, Am R, Aljunid SM. Social and psychological factors affecting eating habits among university students in a Malaysian medical school: A cross-sectional study. Nutr J. 2012;11:48.

Courteney H. Indigestion help sheet. http://hazel-courteney.com/indigestion-help-sheet/. Accessed December 9, 2013.

Akhondi-Meybodi M, Aghaei MA, Hashemian Z. The role of diet in the management of non-ulcer dyspepsia. Middle East journal of digestive diseases. 2015;7(1):19-24.

Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: A cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516-522.

Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. 2007;76(7):1005-1012.

Gralnek IM, Barkun AN, Bardou M. Management of acute bleeding from a peptic ulcer. N Engl J Med. 2008;359(9):928-937.

Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ. Smoking, alcohol, and analgesics in dyspepsia and among dyspepsia subgroups: Lack of an association in a community. Gut. 1994;35(5):619-624.

NHS Choices. Heartburn and gastro-oesophageal reflux disease. 2014; http://www.nhs.uk/Conditions/Gastroesophageal-reflux-disease/Pages/Introduction.aspx. Accessed March 13, 2014.

Fraser A, Delaney BC, Ford AC, Qume M, Moayyedi P. The Short-Form Leeds Dyspepsia Questionnaire validation study. Aliment Pharmacol Ther. 2007;25(4):477-486.

Novis BH, Marks IN, Bank S, Sloan AW. The relation between gastric acid secretion and body habitus, blood groups, smoking, and the subsequent development of dyspepsia and duodenal ulcer. Gut. 1973;14(2):107-112.

Curioso WH, Donaires Mendoza N, Bacilio Zerpa C, Ganoza Gallardo C, León Barúa R. Prevalence and relation of dyspepsia to irritable bowel syndrome in a native community of the Peruvian jungle. Rev Gastroenterol Peru. 2002;22(2):129-140.

Rashed RS, Ayoola EA, Mofleh IA, Chowdhury MN, Mahmood K, Faleh FZ. Helicobacter pylori and dyspepsia in an Arab population. Trop Geogr Med. 1992;44(4):304-307.

Lee YY, Wahab N, Mustaffa N, et al. A Rome III survey of functional dyspepsia among the ethnic Malays in a primary care setting. BMC Gastroenterol. 2013;13:84.

Nandurkar S, Talley NJ, Xia H, Mitchell H, Hazel S, Jones M. Dyspepsia in the community is linked to smoking and aspirin use but not to Helicobacter pylori infection. Arch Intern Med. 1998;158(13):1427-1433.

Abdulghani HM, Alrowais NA, Alhaqwi AI, et al. Cigarette smoking among female students in five medical and nonmedical colleges. Int J Gen Med. 2013;6:719-727.

Carbone F, Holvoet L, Tack J. Rome III functional dyspepsia subdivision in PDS and EPS: recognizing postprandial symptoms reduces overlap. Neurogastroenterol. Motil. 2015;27(8):1069-1074.

Zhu T, Feng B, Wong S, Choi W, Zhu SH. A comparison of smoking behaviors among medical and other college students in China. Health Promot Int. 2004;19(2):189-196.

Petroianu A, Reis DC, Cunha BD, Souza DM. Prevalence of alcohol, tobacco and psychotropic drug use among medical students at the Universidade Federal de Minas Gerais. Rev Assoc Med Bras. 2010;56(5):568-571.

Hyams JS, Burke G, Davis PM, Rzepski B, Andrulonis PA. Abdominal pain and irritable bowel syndrome in adolescents: A community-based study. J Pediatr. 1996;129(2):220-226.

Colledge NR, Walker BR, Ralston SH. Davidson's principles and practice of medicine. 21st ed: Churchill Lingstone Elsevier; 2010.

Khot A, Polmear A. Practical general practice: Guidelines for effective clinical management. 6th ed: Churchill Livingstone Elsevier; 2011.

Carter AO, Elzubeir M, Abdulrazzaq YM, Revel AD, Townsend A. Health and lifestyle needs assessment of medical students in the United Arab Emirates. Med Teach. 2003;25(5):492-496.