Risk Factors of Functional Dyspepsia, Gastrointestinal Reflux Disease and Non-Erosive Reflux Disease
Abstract
Background/Aim: Functional dyspepsia, erosive and non-erosive gastroesophageal reflux disease (GERD) present a major health burden, adversely effecting quality of life. A range of factors are hypothesised to have a positive and negative influence on these diseases. This study aimed to explore the risk factors of functional dyspepsia, gastrointestinal reflux disease and non-erosive reflux disease and its subgroups.
Methods: A cross-sectional study was conducted at Combined Military Hospital (CMH), Lahore, Pakistan, from January to June 2024. Two hundred and twenty-two patients were included and interviewed to fill a tri-section questionnaire comprising a self-designed comprehensive health survey, food frequency questionnaire, gastroesophageal reflux disease questionnaire (GERD-Q), Rome IV criteria, and hospital anxiety and depression scale (HADS).
Results: Participants consisted of 70 controls, 38 GERD, 24 non-erosive reflux disease, 56 functional dyspepsia and 24 overlap reflux-dyspepsia syndrome patients. Subgroups included symptomatic and asymptomatic erosive oesophagitis, epigastric pain syndrome, postprandial distress syndrome and overlap syndrome. Older age, higher BMIs, male gender, low vegetable and yogurt intake, smoking, frequent red meat, high tea/caffeine intake, no postprandial exercise and a short dinner sleep interval were risk factors for GERD and symptomatic erosive esophagitis. Low BMI, female gender and anxiety were strongly associated with functional dyspepsia and non-erosive reflux disease.
Conclusion: Age, BMI, gender, tobacco, anxiety, depression, dietary habits and food frequencies are significant risk factors of dyspepsia and reflux disease.
References
Moayyedi P, Lacy BE, Andrews CN, Enns RA, Howden CW, Vakil N. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013. doi: 10.1038/ajg.2017.154.
Schmulson MJ, Drossman DA. what is new in Rome IV. J Neurogastroenterol Motil. 2017 Apr 30;23(2):151-63. doi: 10.5056/jnm16214.
Wise JL, Locke GR, Zinsmeister AR, Talley NJ. Risk factors for non-cardiac chest pain in the community. Aliment Pharmacol Ther. 2005 Nov 15;22(10):1023-31. doi: 10.1111/j.1365-2036.2005.02666.x.
Sami SS, Ragunath K. The Los Angeles classification of gastroesophageal reflux disease. Video J Encycl GI Endosc. 2013; 1: 103–4. doi.org/10.1016/S2212-0971(13)70046-3.
Caballero-Mateos AM, López-Hidalgo JL, Torres-Parejo Ú, Hernández-González JM, Quintero-Fuentes MD, Caballero-Plasencia AM,, et al. Risk factors for functional dyspepsia, erosive and non-erosive gastroesophageal reflux disease: A cross-sectional study. Gastroenterol Hepatol. 2023 Aug-Sep;46(7):542-52. doi: 10.1016/j.gastrohep.2022.12.005.
Keohane J, Quigley EM. Functional dyspepsia and nonerosive reflux disease: clinical interactions and their implications. MedGenMed. 2007 Aug 8;9(3):31.
Yamasaki T, Hemond C, Eisa M, Ganocy S, Fass R. The changing epidemiology of gastroesophageal reflux disease: are patients getting younger? J Neurogastroenterol Motil. 2018 Oct 1;24(4):559-69. doi: 10.5056/jnm18140.
Krakowska-Stasiak M, Cibor D, Sałapa K, Owczarek D, Mach T. Impact of body weight on clinical symptoms and endoscopic changes in patients with gastroesophageal reflux disease. Przegl Lek. 2016;73(5):271-5. PMID: 29629738
El-Serag H. The association between obesity and GERD: a review of the epidemiological evidence. Dig Dis Sci. 2008 Sep;53(9):2307-12. doi: 10.1007/s10620-008-0413-9.
Beh KH, Chuah KH, Rappek NAM, Mahadeva S. The association of body mass index with functional dyspepsia is independent of psychological morbidity: A cross-sectional study. PLoS One. 2021 Jan 26;16(1):e0245511. doi: 10.1371/journal.pone.0245511.
Le Pluart D, Sabaté JM, Bouchoucha M, Hercberg S, Benamouzig R, Julia C. Functional gastrointestinal disorders in 35,447 adults and their association with body mass index. Aliment Pharmacol Ther. 2015 Apr;41(8):758-67. doi: 10.1111/apt.13143.
Kim YS, Kim N, Kim GH. Sex and gender differences in gastroesophageal reflux disease. J Neurogastroenterol Motil. 2016 Oct 30;22(4):575-88. doi: 10.5056/jnm16138.
Napthali K, Koloski N, Walker MM, Talley NJ. Women and functional dyspepsia. Women’s Health. 2016;12(2):241-50. doi:10.2217/whe.15.88.
Duboc H, Latrache S, Nebunu N, Coffin B. The role of diet in functional dyspepsia management. Front Psychiatry. 2020 Feb 5;11:23. doi: 10.3389/fpsyt.2020.00023.
Yamamoto Y, Furukawa S, Watanabe J, Kato A, Kusumoto K, Miyake T, et al. Association between eating behavior, frequency of meals, and functional dyspepsia in young Japanese population. J Neurogastroenterol Motil. 2022 Jul 30;28(3):418-23. doi: 10.5056/jnm21146.
Xu JH, Lai Y, Zhuang LP, Huang CZ, Li CQ, Chen QK, et al. Certain dietary habits contribute to the functional dyspepsia in south China rural area. Med Sci Monit. 2017 Aug 15;23:3942-51. doi: 10.12659/msm.902705.
Bonetto S, Gruden G, Beccuti G, Ferro A, Saracco GM, Pellicano R. Management of dyspepsia and gastroparesis in patients with diabetes. a clinical point of view in the year 2021. J Clin Med. 2021 Mar 23;10(6):1313. doi: 10.3390/jcm10061313.
Paul S, Abbas MS, Nassar ST, Tasha T, Desai A, Bajgain A, et al. Correlation of anxiety and depression to the development of gastroesophageal disease in the younger population. Cureus. 2022 Dec 19;14(12):e32712. doi: 10.7759/cureus.32712.
Li Q, Duan H, Wang Q, Dong P, Zhou X, Sun K, et al. Analyzing the correlation between gastroesophageal reflux disease and anxiety and depression based on ordered logistic regression. Sci Rep. 2024 Mar 19;14(1):6594. doi: 10.1038/s41598-024-57101-2.
Choi JM, Yang JI, Kang SJ, Han YM, Lee J, Lee C, et al. association between anxiety and depression and gastroesophageal reflux disease: results from a large cross-sectional study. J Neurogastroenterol Motil. 2018 Oct 1;24(4):593-602. doi: 10.5056/jnm18069.
Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and lifestyle factors related to gastroesophageal reflux disease: a systematic review. Ther Clin Risk Manag. 2021 Apr 15;17:305-23. doi: 10.2147/TCRM.S296680.
Baroni L, Bonetto C, Solinas I, Visaggi P, Galchenko AV, Mariani L, et al. Diets including animal food are associated with gastroesophageal reflux disease. Eur J Investig Health Psychol Educ. 2023 Nov 22;13(12):2736-46. doi: 10.3390/ejihpe13120189.
Sadafi S, Azizi A, Pasdar Y, Shakiba E, Darbandi M. Risk factors for gastroesophageal reflux disease: a population-based study. BMC Gastroenterol. 2024 Feb 5;24(1):64. doi: 10.1186/s12876-024-03143-9.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).