Smoking, Alcohol, and Nonsteroidal Anti‐inflammatory Drugs in Outpatients with Functional Dyspepsia and among Dyspepsia Subgroups

Objective: Although there is a paucity of data, environmental factors such as smoking, alcohol, and nonsteroidal anti‐inflammatory drugs (NSAIDs) are helieved to be important in the pathogenesis of functional dyspepsia. We aimed to evaluate, in outpatients presenting for endoscopy, the role of environmental factors in functional dyspepsia. Methods: A consecutive sample of 73 patients with functional dyspepsia completed a validated questionnaire prior to endoscopy. The comparison group consisted of outpatients attending for endoscopy who did not have functional dyspepsia (n = 658). Logistic regression analysis was used to estimate the association between functional dyspepsia and potential risk factors adjusting for age, gender, socioeconomic status, general health, and irritable bowel syndrome. Results: Smoking, alcohol, aspirin, non‐aspirin NSAIDs, and acetaminophen were not associated with functional dyspepsia. Patients were significantly less likely to have functional dyspepsia if they were current or past smokers, and there was a trend for patients to be less likely to have functional dyspepsia if they took NSAIDs regularly. When patients with functional dyspepsia were classified into symptom subgroups, the environmental factors were not found to be associated with ulcer‐like dyspepsia (vs. nonspecific dyspepsia or organic disease). Conclusions: Smoking, alcohol, and NSAIDs are not associated with an increased risk of functional dyspepsia in outpatients presenting for endoscopy.