Researchers Evaluate Risk Factors for Nonerosive GERD, Functional Dyspepsia

An analysis of risk factors for functional dyspepsia (FD) and gastroesophageal reflux disease (GERD) phenotypes found commonalities between patients with nonerosive reflux disease (NERD) and FD, according to study findings published in Gastroenterología y Hepatología.

“NERD and FD share demographic and psychopathological risk factors, which suggests that they may form part of the same pathophysiological spectrum,” wrote corresponding author Antonio M. Caballero-Mateos of San Cecilio University Hospital in Granada, Spain, and study coauthors.

The study included 338 adults from 3 tertiary hospitals in Spain who underwent upper endoscopy. After assessment, 58.6% of patients were classified with GERD, 24% with erosive esophagitis (14.5% symptomatic, 9.5% asymptomatic), 34.6% with NERD, and 52.1% with FD (12.7% epigastric pain syndrome, 10.7% postprandial distress syndrome, 28.7% overlapping syndrome).

Multivariate analysis evaluated associations between epidemiological factors and comorbidities with GERD phenotypes, FD, and Rome-IV syndromes and identified several independent risk factors.

According to the findings, age was significantly associated with NERD and FD; male sex with erosive esophagitis and asymptomatic erosive esophagitis; female sex with FD; body mass index with NERD and FD; use of alcohol with erosive esophagitis; use of calcium channel antagonists with erosive esophagitis; and inhalers with FD.

When researchers compared various patient groups with 45 control participants, they found significantly higher rates of anxiety in patients with NERD, FD, Rome-IV syndromes, and mixed GERD-FD, as well as higher rates of depression in patients with FD, overlapping syndrome, and mixed GERD-FD. Rates of both anxiety and depression, meanwhile, were significantly higher in patients with NERD, FD, overlapping syndrome, and mixed GERD-FD.

“Regarding NERD anxiety was predominant, and in FD anxiety + depression, suggesting that both processes may require complementary psychological therapy,” the authors wrote.

Reference:
Caballero-Mateos AM, López-Hidalgo JL, Torres-Parejo Ú, et al. Risk factors for functional dyspepsia, erosive and non-erosive gastroesophageal reflux disease: a cross-sectional study. Gastroenterol Hepatol. 2023;46(7):542-552. doi: 10.1016/j.gastrohep.2022.12.005