Symptoms but Not Physiology Differentiate Functional Dyspepsia With or Without Overlapping Gastrointestinal Disorders

Area of Science:

• Gastroenterology
• Gut-Brain Interaction
• Functional Gastrointestinal Disorders

Background:

• Functional dyspepsia (FD) frequently overlaps with irritable bowel syndrome (IBS) and reflux.
• Overlapping gastrointestinal (GI) disorders worsen psychological comorbidities and reduce quality of life.
• Limited data exists on physiological parameters in overlapping FD syndromes.

Purpose of the Study:

• To investigate the impact of overlapping disorders and FD subtypes on psychological and GI symptoms.
• To evaluate relevant physiological outcomes in patients with FD and overlapping conditions.
• To compare physiological parameters between FD subtypes.

Main Methods:

• 202 patients with Rome IV FD and overlapping IBS/reflux were analyzed.
• GI and psychological symptoms, and GI-specific quality of life were assessed.
• Physiological measurements included salivary cortisol, gastric emptying, immune activation, and duodenal permeability.

Main Results:

• FD with overlapping disorders exhibited significantly higher GI and psychological symptom severity.
• All measured physiological parameters were comparable between FD with and without overlapping disorders.
• Duodenal eosinophils correlated with anxiety in FD, irrespective of overlap or subtype.

Conclusions:

• The overlap of FD, IBS, and reflux is marked by substantial GI, psychological, and somatic symptom burden.
• Key pathophysiological parameters do not differ significantly between FD with or without overlapping disorders or between FD subtypes.
• Central integration of GI manifestations, rather than peripheral alterations, likely explains the high symptom burden in overlapping FD.