One in 10 adults meet criteria for functional dyspepsia

Last Updated: 2018-02-09

By Reuters Staff

NEW YORK (Reuters Health) - About 10% of the general population has symptoms that meet Rome IV criteria for functional dyspepsia, according to a new study of adults in the U.S., Canada and the UK.

Postprandial distress syndrome was the most common subtype, occurring in 61% of those with dyspepsia, followed by epigastric pain syndrome in 18% and the overlapping subtype (patients with both syndromes) in 12%.

Over 70% of people with dyspepsia show no pathology on endoscopy, and are considered to have functional dyspepsia, Dr. Imran Aziz of the University of Gothenburg in Sweden and colleagues note in their report, online February 1 in The Lancet Gastroenterology & Hepatology.

To investigate prevalence of functional dyspepsia based on the Rome IV criteria, Dr. Aziz and colleagues conducted a health survey of 6,300 adults, who were not told that the study focused on gastrointestinal symptoms. Data were complete for 5,931 study participants.

In the U.S., 12% of survey participants reported symptoms consistent with Rome IV functional dyspepsia, while prevalence was 8% in both Canada and the UK. These individuals had more-impaired health and used more healthcare than their peers without dyspepsia.

Individuals with the overlapping dyspepsia variant had more somatization and a worse quality of life than those with epigastric pain syndrome or postprandial distress syndrome only.

People who reported dyspepsia also were more likely to have symptoms consistent with irritable bowel syndrome (IBS) and functional heartburn; IBS was more common in those with the epigastric-pain-syndrome subtype. Individuals with dyspepsia were predominantly female and younger, on average, than those without dyspepsia.

Survey respondents who reported taking antidepressants were at significantly lower risk of functional dyspepsia (adjusted odds ratio, 0.63), especially postprandial distress syndrome (aOR, 0.61).

American College of Gastroenterology (ACG) and Canadian Association of Gastroenterology (CAG) guidelines define dyspepsia as epigastric pain, the authors note, suggesting that they may not apply to most patients, who have postprandial distress syndrome only.

They conclude: "These findings are likely to increase awareness of the epidemiological scale of functional dyspepsia in the general population and its detrimental effect on general health, and will hopefully aid clinical service and guide research planning, particularly in determining the role of antidepressants."

The findings support the idea that postprandial distress is a distinct disease, Dr. Michael Potter and Dr. Nicholas J. Talley of the University of Newcastle in Callaghan, Australia, note in an editorial accompanying the study.

"Duodenal eosinophilia, impaired barrier function, and impaired neuronal signaling have been observed in postprandial distress, but not in the epigastric pain syndrome, suggesting a unique pathological mechanism, in which an antigenic trigger such as infection, food antigens, or microbiome alterations leads to eosinophilic infiltration, barrier disruption, immune activation and symptom generation in susceptible individuals," they write. "This overarching hypothesis is consistent with these new epidemiologic data."

Dr. Aziz was not available for an interview by press time.

SOURCES: http://bit.ly/2nPBrZk and http://bit.ly/2H0A1TM

Lancet Gastroenterol Hepatol 2018.