Dyspeptic symptoms are common in the general population. 30-40tO of subjects experience some dyspepsia but most never seek medical advice. In order to determine the possible role of H pylori infection in this, we have prospectively studied a random group of healthy subjects who had never consulted the medical profession on account of dyspepsia. Subjects and Methods: Eighty subjects were selected randomly from the general population. They were interviewed by one investigator who scored their

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... eptic symptoms using the Glasgow Dyspepsia Severity Score wnich had been developed and validated in our Unit. It measures dyspeptic symptoms experienced over epreceding six month period. Following this, al[subjects had a 4Curea breath test to determine their H pylori status. They also had their acid output in response to gastrin releasing peptide (40pmollkg/h) measured. The investigator performing the acid secretion tests was blind to the H pylori status of the subjects. Results: Of the 80 subjects, 52 were found to be H pylon negative (36% females, mean age = 31, range: 20-52) and 28 were H pylori positive (37% females, mean age = 33, range: 19-69). The mean dyspeptic score in the H pylori negative group was 1.2 range: 0-7) anfin the H pylori positive group 2.5 (range: 0-8) {p<41.02). Sixty-three percent of those H pylori negative had experienced no dyspepsia over the preceding six months (dyspepsia score = 0) whereas the corresponding figure for those H pylori positive was only 32%. The median acid output in the H pylon negative group was 7.7mmollh (range: 0.5-18.8) and in the H pylor positive group 16.9mmol/h (range: 1.8-37.9) (p<0.005). Linear regression analysis showed that acid output was positively correlated with dyspeptic score within the H pylori positive subject group (r=0.43, p-e0.03). Conclusions: (1) The prevalence of dyspeptic symptoms in the general population with H pylori infection is more than twice that in H pylori negative subjects. (2) The severity of dyspeptic symptoms in those with the infection is positively correlated with the degree of H pylori induced acid hypersecretion.