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. 2022 Jun 15:9:910929.
doi: 10.3389/fmed.2022.910929. eCollection 2022.

Overlap of Gastroesophageal Reflux Disease and Functional Dyspepsia and Yield of Esophagogastroduodenoscopy in Patients Clinically Fulfilling the Rome IV Criteria for Functional Dyspepsia

Duc Trong Quach  1   2 , Quoc Van Ha  3 , Chuyen Thi-Ngoc Nguyen  4 , Quang Dinh Le  1   2 , Doan Thi-Nha Nguyen  1   2 , Nhu Thi-Hanh Vu  1   2 , Ngoc Le-Bich Dang  2 , Nhan Quang Le  2
Affiliations

Overlap of Gastroesophageal Reflux Disease and Functional Dyspepsia and Yield of Esophagogastroduodenoscopy in Patients Clinically Fulfilling the Rome IV Criteria for Functional Dyspepsia

Duc Trong Quach et al. Front Med (Lausanne). .

Abstract

Aim: To assess (1) the overlap rate of gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) and (2) the yield of esophagogastroduodenoscopy in patients clinically presenting with FD.

Materials and methods: Outpatients aged ≥18 years with typical reflux symptoms ≥2 times a week or clinically fulfilling the Rome IV criteria for FD were recruited and underwent esophagogastroduodenoscopy. GERD was classified into non-erosive reflux disease (NERD) and erosive reflux disease (ERD), and FD was classified into epigastric pain syndrome and postprandial distress syndrome. The endoscopic findings that could explain patients' symptoms were considered clinically significant endoscopic findings. After esophagogastroduodenoscopy, patients were categorized into three groups: GERD-only, FD-only, and GERD-FD overlap.

Results: There were 439 patients with a mean age of 42.3 ± 11.6 years. Ninety-one (20.7%) patients had clinically significant endoscopic findings: 73 (16.6%) reflux esophagitis, 6 (1.4%) Barrett's esophagus and 14 (3.2%) gastroduodenal ulcers. After excluding gastroduodenal ulcers, the numbers of patients with GERD-only, FD-only, and GERD-FD overlap were 69 (16.2%), 138 (32.5%), and 218 (51.3%), respectively. Postprandial distress syndrome was more prevalent in GERD-FD overlap than in FD-only (72.9 vs. 44.2%, p < 0.001). The rates of gastroduodenal ulcers in patients clinically fulfilling the criteria for FD with and without reflux symptoms were 0.6 and 4.7%, respectively (p = 0.027).

Conclusion: The GERD-FD overlap was more common than each disorder alone, of which postprandial distress syndrome was significantly prominent. Organic dyspepsia was uncommon in patients clinically fulfilling the Rome IV criteria for FD.

Keywords: Vietnam; dyspepsia; endoscopy; functional dyspepsia; gastroesophageal reflux disease; overlap.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Assessment and classifications of recruited patients before and after endoscopy. FD, functional dyspepsia; GERD, gastroesophageal reflux disease; RE, reflux esophagitis; BR, Barrett’s esophagus; GDU, gastroduodenal ulcer.
FIGURE 2
FIGURE 2
The distribution of epigastric pain syndrome and postprandial distress syndrome across the FD-only and GERD-FD overlap groups. FD, functional dyspepsia; GERD, gastroesophageal reflux disease; ERD, erosive reflux disease; NERD, non-erosive reflux disease.
FIGURE 3
FIGURE 3
The distribution of epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) across FD-only and GERD-FD overlap groups. FD, functional dyspepsia; GERD, gastroesophageal reflux disease; ERD, erosive reflux disease; NERD, non-erosive reflux disease.
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