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Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders in Patients with Chronic Hepatitis C Virus
Alshymaa Hassnine1, Zeinab Saad1
1Department of Gastroenterology, and Tropical Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
Insights
Functional gastrointestinal disorders (FGIDs) like functional dyspepsia and inflammatory bowel syndrome are common in patients with chronic hepatitis C virus (HCV). Obesity and higher fibrosis scores predict functional dyspepsia, while male gender predicts IBS in HCV patients.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Chronic hepatitis C virus (HCV) infection frequently presents with unexplained abdominal symptoms.
- Functional gastrointestinal disorders (FGIDs) are often implicated as the cause of these symptoms in HCV patients.
- This study investigates the prevalence of FGIDs in chronic HCV patients.
Purpose of the Study:
- To evaluate the prevalence of functional gastrointestinal disorders (FGIDs) in patients with chronic hepatitis C virus (HCV).
- To identify factors associated with functional dyspepsia (FD) and inflammatory bowel syndrome (IBS) in HCV patients using Rome IV criteria.
Main Methods:
- A cross-sectional study involving 1006 patients with chronic HCV and 500 controls.
- Utilized Rome IV diagnostic criteria and questionnaires to assess FGIDs.
- Collected medical history, basic investigations, and specific tests like HCV RNA PCR and upper GIT endoscopy.
Main Results:
- HCV patients exhibited higher rates of FGIDs, including functional dyspepsia (FD) and inflammatory bowel syndrome (IBS).
- Factors predicting FD in HCV patients included high BMI, education, positive PCR, and fibrosis stage.
- Predictors for IBS in HCV patients were male gender, high BMI, urban residence, education, positive PCR, and fibrosis stage.
Conclusions:
- Functional dyspepsia is highly prevalent in obese HCV patients with advanced fibrosis.
- Inflammatory bowel syndrome is also common among male patients with chronic HCV.
- FGIDs represent a significant comorbidity in the management of chronic hepatitis C.
Abstract:
BACKGROUND: Patients with chronic hepatitis C virus (HCV) usually have different abdominal complaints without any organic lesions. The functional cause of these complaints is claimed in most patients. This study aimed to evaluate functional gastrointestinal disorders (FGIDs) in patients with chronic hepatitis C using Rome IV diagnostic criteria. METHODS: This study included 1506 participants (1006 patients with chronic HCV, and 500 controls). All individuals were subjected to taking thorough medical history, basic investigations (complete blood counts, liver and renal functions tests), international normalized ratio (INR), alpha-fetoprotein, HCV RNA PCR (polymerase chain reaction), abdominal ultrasonography, and upper gastrointestinal tract (GIT) endoscopy for patients only), and Rome IV diagnostic questionnaire. RESULTS: Patients with HCV had symptoms of FGIDs including functional dyspepsia (FD) (P=0.009), early satiety (P=0.002), postprandial distress (P=0.02), epigastric pain (P=0.03), Inflammatory bowel syndrome (IBS) (P<0.001), IBS predominant constipation (P<0.001), IBS predominant diarrhea (P<0.001), and IBS mixed (P<0.001). There were multiple factors for the prediction of FD in patients with HCV, including high body mass index (BMI), education level, positive polymerase chain reaction (PCR), and fibrosis stage. Also, there were multiple factors for the prediction of IBS in patients with HCV, including male gender, high BMI, urban residence, education level, positive PCR, and fibrosis stage. CONCLUSIONS: FD is a prevalent finding in obese patients with HCV and with higher fibrosis scores. IBS is also prevalent in male patients with HCV.
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