RT Journal Article
SR Electronic
T1 Distinct aetiopathogenesis in subgroups of functional dyspepsia according to the Rome III criteria
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1517
OP 1528
DO 10.1136/gutjnl-2014-308114
VO 64
IS 10
A1 Fang, Yu-Jen
A1 Liou, Jyh-Ming
A1 Chen, Chieh-Chang
A1 Lee, Ji-Yuh
A1 Hsu, Yao-Chun
A1 Chen, Mei-Jyh
A1 Tseng, Ping-Huei
A1 Chen, Chien-Chuan
A1 Chang, Chi-Yang
A1 Yang, Tsung-Hua
A1 Chang, Wen-Hsiung
A1 Wu, Jeng-Yi
A1 Wang, Hsiu-Po
A1 Luo, Jiing-Chyuan
A1 Lin, Jaw-Town
A1 Shun, Chia-Tung
A1 Wu, Ming-Shiang
YR 2015
UL http://gut.bmj.com/content/64/10/1517.abstract
AB Background and objective Whether there is distinct pathogenesis in subgroups of functional dyspepsia (FD), the postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) remains controversial. We aimed to identify the risk factors of FD and its subgroups in the Chinese population.Methods Patients with dyspepsia and healthy subjects who underwent gastric cancer screening were enrolled in this multicentre study from 2010 to 2012. All patients were evaluated by questionnaire, oesophagoduodenoscopy, histological examination and Helicobacter pylori tests. Subgroups of FD were classified according to the Rome III criteria. Psychiatric stress was assessed by the short form Brief Symptom Rating Scale. CagA and VacA genotypes were determined by PCR.Results Of 2378 patients screened for eligibility, 771 and 491 fulfilled the diagnostic criteria of uninvestigated dyspepsia and FD, respectively. 298 (60.7%) and 353 (71.9%) individuals were diagnosed with EPS and PDS, respectively, whereas 169 (34.4%) had the overlap syndrome. As compared with 1031 healthy controls, PDS and EPS shared some common risk factors, including younger age (OR 0.95; 99.5% CI 0.93 to 0.98), non-steroidal anti-inflammatory drugs (OR 6.60; 99.5% CI 3.13 to 13.90), anxiety (OR 3.41; 99.5% CI 2.01 to 5.77) and concomitant IBS (OR 6.89; 99.5% CI 3.41 to 13.94). By contrast, H. pylori (OR 1.86; 99.5% CI 1.01 to 3.45), unmarried status (OR 4.22; 99.5% CI 2.02 to 8.81), sleep disturbance (OR 2.56; 99.5% CI 1.29 to 5.07) and depression (OR 2.34; 99.5% CI 1.04 to 5.36) were associated with PDS. Moderate to severe antral atrophy and CagA positive strains were also more prevalent in PDS.Conclusions Different risk factors exist among FD subgroups based on the Rome III criteria, indicating distinct aetiopathogenesis of the subdivisions that may necessitate different therapeutic strategies.