Duodenal eosinophilia poses heightened risk of GERD in individuals with FD, PDS
Duodenal eosinophilia carries up to a sixfold increased risk of developing gastro-oesophageal reflux disease (GERD) over 10 years in individuals with functional dyspepsia (FD) and postprandial distress syndrome (PDS), a study has found.
Researchers randomly selected 1,000 adults for an oesophagogastroduodenoscopy and a more comprehensive abdominal symptom questionnaire and medical history, among whom 703 (mean age, 63.2 years; 51.9 percent female) attended the follow-up evaluation after 10 years. A case‐control study on all available FD patients with histological evaluation of the duodenum at baseline (n=89) vs healthy controls (n=124) was also conducted.
Concomitant GERD symptoms (with no oesophagitis or other organic disease at baseline) presented in 54 FD patients at baseline. On the other hand, 68 individuals reported any GERD symptoms at follow‐up (overlap in 44), of whom 24 had developed new-onset GERD.
On logistic regression analysis, the risk of developing GERD at follow-up was significantly high in patients with FD (odds ratio [OR], 7.6, 95 percent CI, 2.93–19.4; p<0.001) or PDS (OR, 9.0, 3.36–24.0; p<0.001) at baseline. Eosinophilia in the second part of duodenum only showed an independent association with an elevated risk of new-onset GERD among patients with baseline FD (OR, 4.2, 1.2–4.77; p=0.024) or PDS (OR, 6.0, 1.50–23.6; p=0.011).
The present data suggest that duodenal eosinophilia may explain the link between GERD and FD via impaired gastric accommodation and increased transient lower oesophageal sphincter relaxations, the researchers pointed out. The study also supports the concept of FD and GERD being part of the same disease spectrum.