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Inicio Gastroenterología y Hepatología Risk factors for functional dyspepsia, erosive and non-erosive gastroesophageal ...
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Vol. 46. Issue 7.
Pages 542-552 (August - September 2023)
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Vol. 46. Issue 7.
Pages 542-552 (August - September 2023)
Original article
Risk factors for functional dyspepsia, erosive and non-erosive gastroesophageal reflux disease: A cross-sectional study
Factores de riesgo en dispepsia funcional y enfermedad por reflujo gastroesofágico: un estudio transversal
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Antonio M. Caballero-Mateosa,
Corresponding author
ogy1492@hotmail.com

Corresponding author.
, Javier L. López-Hidalgob, Úrsula Torres-Parejoc, Juan M. Hernández-Gonzálezd,1, María Dolores Quintero-Fuentesa, Antonio M. Caballero-Plasenciae, Eduardo Redondo-Cerezof
a Gastroenterology Department, San Cecilio University Hospital, Granada, Spain
b Pathology Department, San Cecilio University Hospital, Granada, Spain
c Statistics and OI Department, University of Granada, Spain
d University of Central Florida, Orlando, USA
e University of Granada, Spain
f Gastroenterology Department, Virgen de las Nieves University Hospital, Granada, Spain
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Tables (5)
Table 1. Classification of the different groups analyzed.
Table 2. Prevalence of GERD, FD, and their respective subgroups in 357 patients with upper gastrointestinal symptoms. NERD and FD group did not exclude ORDS patients.
Table 3. Demographic, toxic and medication data, and comorbidities in controls and different subgroups of Gastroesophageal Reflux Disease and Functional Dyspepsia.
Table 4. Univariate analysis of factors associated with different groups and subgroups of GERD and FD.
Table 5. Multivariate analysis (logistic regression) of factors associated with different groups and subgroups of GERD and FD.
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Abstract
Background

Conflicting data exists regarding risk factors associated with Gastroesophageal Reflux Disease (GERD) and Functional Dyspepsia (FD). Few studies examine anxiety/depression in relation to GERD phenotypes (Esophagitis/EE, and Non-Erosive Reflux Disease/NERD), FD, and Rome-IV syndromes. Our aim was to evaluate the association between epidemiological factors and comorbidities with GERD phenotypes, FD, and Rome-IV syndromes, as well as their relationship with anxiety/depression.

Methods

338 subjects were selected from 357 patients referred to three tertiary-centers for endoscopic evaluation. Every subject was interviewed individually to administer three validated questionnaires: GERD-Q, Rome-IV and HADS.

Results

45/338 patients were controls, 198/58.6% classified as GERD, 81/24.0% EE (49/14.5% symptomatic, and 32/9.5% asymptomatic), 117/34.6% NERD, 176/52.1% FD (43/12.7% epigastric pain syndrome, 36/10.7% postprandial distress syndrome, and 97/28.7% overlapping syndrome). 81 patients were mixed GERD-FD. Multivariate analysis found significant independent associations: age in NERD and FD; sex in EE, asymptomatic EE and FD; body mass index in NERD and FD; alcohol in EE; anxiety/depression in FD; use of calcium channel antagonists in EE; and inhalers in FD. We compared controls vs different groups/subgroups finding significantly more anxiety in NERD, FD, all Rome-IV syndromes, and mixed GERD-FD; more depression in FD, overlapping syndrome, and mixed GERD-FD; and higher levels of anxiety+depression in NERD, FD, overlapping syndrome, and mixed GERD-FD.

Conclusions

NERD and FD share demographic and psychopathological risk factors which suggests that they may form part of the same pathophysiological spectrum. Regarding NERD anxiety was predominant, and in FD anxiety+depression, suggesting that both processes may require complementary psychological therapy.

Keywords:
GERD
NERD
Functional dyspepsia
Anxiety
Depression
Abbreviations:
AEE
EE
EPS
FD
GERD
LES
NERD
OLS
ORDS
PDS
SEE
Resumen
Antecedentes

Existen datos controvertidos sobre los factores de riesgo asociados a la enfermedad por reflujo gastroesofágico (ERGE) y la dispepsia funcional (DF). Pocos estudios han evaluado la relación entre ansiedad/depresión y los diferentes fenotipos de la DF (criterios Roma IV) y de la ERGE (erosiva [EE] y no erosiva [NERD]). Nuestro objetivo fue valorar la asociación entre diferentes factores epidemiológicos y comorbilidades y los fenotipos de la ERGE, la DF y sus síndromes, y su relación con la ansiedad/depresión.

Métodos

Se seleccionaron 338 pacientes entre 357 remitidos para estudio endoscópico en 3 hospitales terciarios. Cada uno fue entrevistado individualmente y completó 3 cuestionarios validados: GERD-Q, Roma IV y HADS.

Resultados

Cuarenta y cinco de los 338 pacientes fueron controles. Se clasificaron 198/58,6% como ERGE, 81/24,0% como EE (49/14,5% sintomática y 32/9,5% asintomática), 117/34,6% como NERD y 176/52,1% como DF (43/12,7% síndrome de dolor epigástrico, 36/10,7% síndrome de molestias posprandiales y 97/28,7% solapamiento epigastralgia-molestias posprandiales). Ochenta y uno solapaban ERGE-DF. El análisis multivariante encontró las siguientes asociaciones significativas: edad en NERD y DF; sexo en EE, EE asintomática y DF; IMC en NERD y DF; alcohol en EE; ansiedad/depresión en DF; toma de antagonistas del calcio en EE e inhaladores en DF. Al comparar el grupo control vs. diferentes grupos/subgrupos encontramos significativamente más ansiedad en NERD, solapamiento DF-ERGE, DF y todos sus síndromes Roma IV; más depresión en DF, solapamientos epigastralgia-molestias posprandiales y ERGE-DF; y más ansiedad+depresión en NERD, DF y solapamientos epigastralgia-molestias posprandiales y ERGE-DF.

Conclusiones

La DF y la NERD comparten factores de riesgo demográficos y psicopatológicos, lo que evidencia que forman parte de un mismo espectro fisiopatológico. En la NERD predomina la ansiedad y en la DF la ansiedad+depresión, apuntando a que ambos procesos podrían precisar terapia psicológica complementaria.

Palabras clave:
ERGE
NERD
Dispepsia funcional
Ansiedad
Depresión

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