Ronkainen, J, Aro, P, Walker, MM, et al. Duodenal eosinophilia is associated with functional dyspepsia and new onset gastro‐oesophageal reflux disease. Aliment Pharmacol Ther. 2019; 50: 24– 32. https://doi.org/10.1111/apt.15308
Duodenal eosinophilia is associated with functional dyspepsia and new onset gastro‐oesophageal reflux disease
|Author:||Ronkainen, Jukka1,2,3; Aro, Pertti4; Walker, Marjorie5,6;|
1Center for Life Course Health Research, University of Oulu
2Primary Health Care Center, Tornio, Finland
3Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
4Arokero OY, Tornio, Finland
5Faculty of Health and Medicine, Priority Research Center for Digestive Health and Neurogastroenterology, University of Newcastle, Callaghan, NSW, Australia
6Australian GI Research Alliance (AGIRA), Canberra, Australia
7Psychology Department, Macquarie University, North Ryde, NSW, Australia
|Online Access:||PDF Full Text (PDF, 1.2 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe202101071193
John Wiley & Sons,
|Publish Date:|| 2021-01-07
Background: It is unexplained why functional dyspepsia and gastro‐oesophageal reflux disease (GERD) overlap more often than expected by chance. Post‐prandial distress syndrome has been linked to impaired gastric fundic accommodation which may induce increased transient lower oesophageal sphincter relaxations and consequent GERD. Duodenal eosinophilia has been linked to functional dyspepsia and post‐prandial distress syndrome.
Aim: To identify if there is an association between duodenal eosinophilia in functional dyspepsia and symptoms of GERD and whether post‐prandial distress syndrome or epigastric pain syndrome are associated with new onset GERD.
Methods: Participants (n = 1000) were randomly selected from the national Swedish population register and surveyed by questionnaires and oesophagogastroduodenoscopy in 1999‐2001. All eligible subjects (n = 887) were invited to a follow‐up study in 2010 (response rate 79%). In a case‐control study of 213 subjects (functional dyspepsia vs healthy controls), histology from the duodenum was evaluated at baseline and the possible association of eosinophilia to new onset GERD symptoms was analysed.
Results: Functional dyspepsia (OR 7.6; 95% CI 2.93‐19.4, P < 0.001) and post‐prandial distress syndrome at baseline (OR 9.0, 95% CI 3.36‐24.0, P < 0.001) were associated with an increased risk of GERD at follow‐up. Eosinophilia in the second part of duodenum only was independently associated with an increased risk of GERD amongst those with functional dyspepsia (OR 4.2; 95% CI 1.2‐4.77, P = 0.024) and post‐prandial distress syndrome at baseline (OR 6.0; 95% CI 1.50‐23.6, P = 0.011), respectively.
Conclusions: Duodenal eosinophilia is associated with increased risk of GERD at 10‐year follow‐up in those with functional dyspepsia and post‐prandial distress syndrome at baseline. Duodenal eosinophilia may explain the link between GERD and functional dyspepsia, suggesting subsets of functional dyspepsia and GERD may be part of the same disease spectrum.
Alimentary pharmacology and therapeutics
|Pages:||24 - 32|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3141 Health care science
Swedish Research Council; Swedish Society of Medicine; Norrbotten County Council (Sweden); Astra Zeneca R&D (Sweden); Orion Research Foundation (Finland); Finnish Medical Foundation; Finnish Society of Medicine Duodecim; Vappu and Oskari Yli‐Perttula's Foundation; National Health and Medical Research Council. Grant Numbers: APP1061004, APP1084544.
© 2019 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Ronkainen, J, Aro, P, Walker, MM, et al. Duodenal eosinophilia is associated with functional dyspepsia and new onset gastro‐oesophageal reflux disease. Aliment Pharmacol Ther. 2019; 50: 24– 32, which has been published in final form at https://doi.org/10.1111/apt.15308. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.