Dyspepsia epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahad Hasan, M.D.[2] Ajay Gade MD[3]]
Overview
Dyspepsia is a common upper gastrointestinal symptom complex encompassing both uninvestigated dyspepsia and functional dyspepsia (a disorder of gut-brain interaction defined by Rome IV criteria). Global pooled prevalence estimates vary substantially by definition: uninvestigated dyspepsia affects approximately 20.8% of the general population (95% CI 17.8–23.9%), while Rome-criteria-defined functional dyspepsia has a global pooled prevalence of 8.4% (95% CI 7.4–9.5%), and in the most recent Rome Foundation internet-based epidemiology study, 7.2% (range 2.2%–12.3% across countries). Prevalence is consistently higher in women than in men across all diagnostic criteria and is higher in developing countries than in developed countries. The global prevalence of functional dyspepsia has declined gradually over the past three decades, from 12.4% in studies conducted during 1990–2002 to 7.3% in studies conducted during 2013–2020, and it decreases with advancing age, findings that contrast with the age-related increase seen with H. pylori infection. Postprandial distress syndrome is the dominant clinical subtype of functional dyspepsia, accounting for approximately two-thirds of cases, followed by epigastric pain syndrome and an overlapping PDS/EPS phenotype. Functional dyspepsia is strongly associated with anxiety, depression, reduced physical quality of life, and increased healthcare utilization, but has not been shown to be associated with increased long-term mortality.
Epidemiology and Demographics
Global Prevalence of Dyspepsia and Functional Dyspepsia
- According to a 2015 meta-analysis of 100 study populations comprising 312,415 subjects, the global pooled prevalence of uninvestigated dyspepsia was 20.8% (95% CI 17.8–23.9%), ranging from 1.8% to 57.0% depending on the country and diagnostic definition used.[1]
- A 2024 systematic review and meta-analysis of 44 studies, including 256,915 participants from 40 countries across six continents, found the global pooled prevalence of Rome-criteria-defined functional dyspepsia to be 8.4% (95% CI 7.4–9.5%).[2]
- Prevalence estimates vary substantially according to the Rome diagnostic criteria version applied, being highest with Rome I criteria (11.9%; 95% CI 5.1–25.4%) and lowest with Rome IV criteria (6.8%; 95% CI 5.8–7.9%).[2]
- The 2025 Rome Foundation Global Epidemiology Study, an internet survey of 54,127 respondents from 26 countries, found a pooled Rome IV functional dyspepsia prevalence of 7.2%, ranging from 2.2% in Japan to 12.3% in Egypt.[3]
- Global prevalence of functional dyspepsia has declined gradually over time, from 12.4% (95% CI 8.2–18.3%) in studies conducted during 1990–2002 to 7.3% (95% CI 6.1–8.7%) in studies conducted during 2013–2020.[2]
| Global Prevalence of Functional Dyspepsia by Rome Diagnostic Criteria | |||
|---|---|---|---|
| Rome Criteria | Studies | Participants | Pooled Prevalence (95% CI) |
| Rome I | 3 | 10,278 | 11.9% (5.1–25.4%) |
| Rome II | 5 | 5,742 | 10.6% (6.1–17.7%) |
| Rome III | 27 | 150,923 | 10.8% (8.7–13.4%) |
| Rome IV | 45 | 89,972 | 6.8% (5.8–7.9%) |
| Global Prevalence of Functional Dyspepsia by Study Time Period (1990–2020) | |||
|---|---|---|---|
| Time Period | Studies | Participants | Pooled Prevalence (95% CI) |
| 1990–2002 | 8 | 15,578 | 12.4% (8.2–18.3%) |
| 2003–2012 | 15 | 56,840 | 10.1% (7.8–13.1%) |
| 2013–2020 | 53 | 132,931 | 7.3% (6.1–8.7%) |
Risk Factors
- In the 2015 meta-analysis of uninvestigated dyspepsia, several factors were only modestly associated with dyspepsia in the community: female sex (OR 1.24, 95% CI 1.13–1.36), current smoking (OR 1.25, 95% CI 1.12–1.40), NSAID use (OR 1.59, 95% CI 1.27–1.99), and H. pylori-positive status (OR 1.18, 95% CI 1.04–1.33).[1]
- The authors concluded that because these classic risk factors showed only modest associations, cultural, ethnic, genetic, and dietary factors may play a more important role in the community prevalence of dyspepsia.[1]
| Risk Factors for Uninvestigated Dyspepsia | |
|---|---|
| Risk Factor | Odds Ratio (95% CI) |
| Female sex | 1.24 (1.13–1.36) |
| Current smoking | 1.25 (1.12–1.40) |
| NSAID use | 1.59 (1.27–1.99) |
| H. pylori-positive status | 1.18 (1.04–1.33) |
Prevalence
- The prevalence of eosinophilic gastritis is approximately 6.3 per 100,000 individuals worldwide.[4]
- The global pooled prevalence of uninvestigated dyspepsia is 20.8% (95% CI 17.8–23.9%), while Rome-criteria-defined functional dyspepsia has a global pooled prevalence of 8.4% (95% CI 7.4–9.5%), most recently estimated at 7.2% (range 2.2–12.3%) in the 2025 Rome IV Global Epidemiology Study (see above).[1][2][3]
Functional Dyspepsia Subtypes
- In the 2025 Rome IV Global Epidemiology Study, postprandial distress syndrome was the dominant subtype of functional dyspepsia (66.6%), followed by epigastric pain syndrome (15.3%) and an overlapping postprandial distress syndrome/epigastric pain syndrome phenotype (18.1%).[3]
- Both postprandial distress syndrome (OR 1.60, 95% CI 1.49–1.72) and epigastric pain syndrome (OR 1.42, 95% CI 1.27–1.59) were significantly more prevalent in women, and both decreased in prevalence with advancing age.[3]
- Among individuals meeting criteria for functional dyspepsia, overlap with other disorders of gut-brain interaction was common: irritable bowel syndrome (Rome IV) in 26.1%, functional heartburn in 9.0%, and chronic nausea and vomiting syndrome in 7.0%.[3]
| Functional Dyspepsia Subtype Distribution (Rome IV Global Epidemiology Study) | |
|---|---|
| Subtype | Proportion of Functional Dyspepsia Cases |
| Postprandial distress syndrome (PDS) | 66.6% |
| Epigastric pain syndrome (EPS) | 15.3% |
| Overlapping PDS and EPS | 18.1% |
Healthcare Utilization and Economic Burden
- In the 2025 Rome IV Global Epidemiology Study, 53.1% (95% CI 51.6–54.7%) of individuals with functional dyspepsia had visited a physician for their symptoms, including 39.9% (95% CI 38.4–41.4%) who saw a primary care physician and 27.1% (95% CI 25.8–28.5%) who saw a gastroenterologist.[3]
- Individuals with the overlapping PDS/EPS phenotype had the highest rate of physician visits (70.1%, 95% CI 66.7–73.5%), compared with 34.4% (95% CI 34.0–34.8%) for PDS alone and 34.5% (95% CI 34.1–34.9%) for EPS alone.[3]
- Medication use was substantially higher among individuals with functional dyspepsia compared with those without: acid-suppressive medications 43.0% (95% CI 41.5–44.6%) versus 18.7% (95% CI 18.3–19.0%); prescription pain medications 32.9% (95% CI 31.5–34.4%) versus 16.1% (95% CI 15.8–16.5%); anxiolytics 19.7% (95% CI 18.5–20.9%) versus 8.1% (95% CI 7.8–8.3%); and antidepressants 17.2% (95% CI 16.1–18.4%) versus 8.0% (95% CI 7.7–8.2%).[3]
| Healthcare Utilization: Functional Dyspepsia vs. No Functional Dyspepsia | ||
|---|---|---|
| Measure | Functional Dyspepsia (95% CI) | No Functional Dyspepsia (95% CI) |
| Physician visit for symptoms | 53.1% (51.6–54.7%) | — |
| Acid-suppressive medication use | 43.0% (41.5–44.6%) | 18.7% (18.3–19.0%) |
| Prescription pain medication use | 32.9% (31.5–34.4%) | 16.1% (15.8–16.5%) |
| Anxiolytic use | 19.7% (18.5–20.9%) | 8.1% (7.8–8.3%) |
| Antidepressant use | 17.2% (16.1–18.4%) | 8.0% (7.7–8.2%) |
| Cholecystectomy | 7.4% (6.6–8.2%) | 4.8% (4.6–5.0%) |
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Ford AC, Marwaha A, Sood R, Moayyedi P (2015). "Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis". Gut. 64 (7): 1049–1057. doi:10.1136/gutjnl-2014-307843. PMID 25147201.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Lee K, Kwon CI, Yeniova AÖ, Koyanagi A, Jacob L, Smith L, Lee SW, Rahmati M, Shin JY, Shin JI, Cho W, Yon DK (2024). "Global prevalence of functional dyspepsia according to Rome criteria, 1990-2020: a systematic review and meta-analysis". Sci Rep. 14 (1): 4172. doi:10.1038/s41598-024-54716-3. PMID 38378941 Check
|pmid=value (help). - ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 Tack J, Palsson OS, Bangdiwala SI, Schol J, Carbone F, Van Den Houte K, Broeders B, Drossman D, Dumitrascu DL, Fang X, Fukudo S, Ghoshal UC, Kellow J, Khatun R, Okeke E, Quigley EM, Schmulson M, Simren M, Whitehead WE, Whorwell P, Sperber AD (2025). "Functional Dyspepsia and Its Subgroups: Prevalence and Impact in the Rome IV Global Epidemiology Study". Aliment Pharmacol Ther. 62 (3): 330–339. doi:10.1111/apt.70189. PMID 40434285 Check
|pmid=value (help). - ↑ Jensen ET, Martin CF, Kappelman MD, Dellon ES (2016). "Prevalence of Eosinophilic Gastritis, Gastroenteritis, and Colitis: Estimates From a National Administrative Database". J Pediatr Gastroenterol Nutr. 62 (1): 36–42. doi:10.1097/MPG.0000000000000865. PMC 4654708. PMID 25988554.