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Published on: June 29, 2019
The Associations Between Acid-Suppressive Drug Intake and Symptom Profiles in Functional Dyspepsia Patients Referred
Scheepers Janne1, Carbone Florencia1,2, Matheussen Hanne1
1Neurosensitivity & Motility, TARGID, KU Leuven, Leuven, Belgium.
Background:
Functional dyspepsia (FD) is characterised by postprandial fullness, early satiation, epigastric pain, or burning without structural abnormalities on upper endoscopy. Proton pump inhibitors (PPIs) are the preferred first-line therapy. Given that the diagnosis of FD is largely based on symptom assessment, it remains unclear whether acid-suppression meaningfully influences symptom presentation.
Objective:
This exploratory study aimed to determine the prevalence of acid-suppressive therapy (PPIs or H2 receptor antagonists (H2RAs)) among FD patients and to compare symptom patterns between patients with and without these treatments.
Methods:
In this single-centre, cross-sectional observational study, ambulatory patients referred for diagnostic upper endoscopy completed the Waiting Room Questionnaire (WRQ). Endoscopic findings were recorded, and FD was defined using Rome IV. Acid-suppression was defined as self-reported use of PPIs or H2RAs. Symptom frequency was compared between patients on and off therapy.
Results:
1158 patients completed the WRQ; 27% fulfiled the criteria for FD. Among FD patients, 60% reported acid-suppressive therapy, similar to patients with endoscopic findings. FD patients receiving acid-suppression reported higher frequencies of early satiation (OR = 1.68, 95% CI 1.08-2.60), nausea (OR = 1.93, 95% CI 1.23-3.01), and epigastric pain (OR = 1.74, 95% CI 1.12-2.69). In subgroup analyses, therapy was associated with more frequent epigastric burning in postprandial distress syndrome (OR = 3.81, 95% CI 1.50-9.67) and higher frequencies of postprandial fullness (OR = 2.90, 95% CI 1.24-6.80) and early satiation (OR = 2.34, 95% CI 1.13-4.85) in the overlap subgroup.
Conclusions:
FD is prevalent in open-access endoscopy, and acid-suppressive therapy is frequently used in this population. FD patients receiving acid-suppression reported slightly higher frequencies of several symptoms, highlighting the need to further explore these associations.
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