Exocrine pancreatic function and chronic unexplained dyspepsia

Smith, Ross C.; Talley, Nicholas J.; Dent, Owen F.; Jones, Michael; Waller, Sheila L.

doi:10.1007/bf02924544

Cited by 19 publications

(3 citation statements)

References 18 publications

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“…Ancak pankreas patolojilerinin hiçbirisi dispepsisi olan hastalarda tam olarak gösterilebilmiş değildir (27). Bir diğer çalışmada fonksiyonel dispepsili hastalara endosonografi (EUS) uygulanmış ve pankreas anomalileri normal kontrol hastalarına oranla bu hastalarda daha yüksek bulunmuştur (28). Okatha ve arkadaşları çalışmasında da fonksiyonel dispepsi kabul edilmiş hastaların serum amilaz, lipaz değerleri karşılaştırılmış, lipaz seviyesi organik dispepsili gruba göre yüksek bulunmuştur.…”

Section: Bulgularunclassified

To investigate possible etiologic factors of organic and functional dyspepsia in Turkey

Karabulut¹,

Karabulut²,

Akarsu³

et al. 2015

Bakirkoy

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Araştırmalar / ResearchesÖZET Türk toplumunda organik ve fonksiyonel dispepsili hastalarda etyolojiye yönelik analiz Amaç: Dispepsi gastrointestinal kaynaklı spesifik olmayan semptomlar topluluğu olarak tanımlanabilir ve başvuran hastalarda yakınmaların nedenini ortaya koymak için yapılan incelemelerde dispepsiye neden olabilecek patolojiler saptanabilirse bu tür dispepsiler organik dispepsi, lokal veya sistemik bir hastalık sorumlu olarak bulunamamış dispepsiler ise fonksiyonel dispepsi olarak tanımlanırlar. Amacımız Türk toplumunda organik ve fonksiyonel dispepsi prevalansını saptamak ve muhtemel etyolojik faktörleri incelemektir. Gereç ve Yöntem: Çalışmamız, prospektif olarak planlandı ve Haziran 2008 tarihinden itibaren dispepsi şikâyetleri ile başvuran ilk 200 erişkin hasta cinsiyet gözetilmeksizin ve 100 hasta ise kontrol grubu olarak çalışmaya alındı. Çalışmamıza dahil edilen tüm hastalar hemogram, biyokimya tetkikleri, gaita tetkikleri, üst gastrointestinal endoskopi, tüm batın ultrasonografi ile değerlendirildi. Ülser, gastrit ve safra kesesinde patoloji tespit edilen hastalar organik dispepsili olarak kabul edildi. Bulgular: Dispepsi şikayeti olan 200 hastanın 71'inde (%35.5) üst gastrointestinal endoskopisinde gastrit veya ülser, 33'ünde (%16.5) tüm batın ultrasonografisinde safra kesesinde kalkül veya çamur tespit edildi. Hem mide patolojisi hem de safra kesesi patolojisi olan hasta sayısı ise 12 (%6) idi. Organik dispepsi grubundaki hasta sayısı sonuç olarak 92 oldu. Geri kalan ne ultrasonografi de ne de üst gastrointestinal endoskopisinde bulgu tespit edilmeyen 108 hasta ise fonksiyonel dispepsi grubuna dahil edildi. Sonuçlar: Çalışmamızda dispepsili hastaların %46'sında organik bir sebep ortaya konabildi. Organik dispepsilerin en önemli sebebi üst gastrointestinal patolojilerdi (organik dispepsilerin %77'si). Çalışmamızda fonksiyonel dispepsili hastalarda yapılan biyokimyasal araştırmalarda serum amilaz ve lipaz düzeyi de dahil hiçbir parametrenin kontrol grubundan farklı olmadığı bulundu Anahtar kelimeler: Fonksiyonel dispepsi, organik dispepsi, pankreatik bozukluklar, lipaz

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Section: Bulgularunclassified

To investigate possible etiologic factors of organic and functional dyspepsia in Turkey

Karabulut¹,

Karabulut²,

Akarsu³

et al. 2015

Bakirkoy

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“…FD can also encompass chronic pancreatitis who are complicated with abdominal fullness, epigastric pain, and early satiety [ 3 ]. Andersen et al and Smith et al reported that a portion of the population of FD patients had pancreatic enzyme abnormalities and chronic pancreatitis [ 4 , 5 ]. In 2015, the Japanese Society of Gastroenterology (JSGE) reported new guidelines for FD and demonstrated that among FD patients, 24% had chronic pancreatitis (CP) [ 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Trypsin may be associated with duodenal eosinophils through the expression of PAR2 in early chronic pancreatitis and functional dyspepsia with pancreatic enzyme abnormalities

Agawa

Futagami²,

Yanagawa³

et al. 2022

PLoS ONE

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Background Early chronic pancreatitis (ECP) has been reported to advance into chronic pancreatitis, it may be critical to differentiate the pathophysiology of ECP and functional dyspepsia (FD) in patients with pancreatic enzyme abnormalities (FD-P). This study aimed to clarify differences in the pathophysiology of ECP and FD-P and to determine whether duodenal inflammatory responses in the two diseases were associated with protease-activated receptor (PAR) 2, as the trypsin receptor. Methods Eighty patients who presented with FD-P and ECP were enrolled. In duodenal specimens, PAR2 mRNA levels were determined using real-time PCR. Using immunostaining, CD68-, GLP-1-, PRG2-, and CCR2-positive cells, tight junction proteins, and PAR 2 were evaluated. Results There were no significant differences in clinical symptoms and gastric motility between ECP and FD-P patients. The CD68-positive cells infiltrations and occludin expression levels in the duodenal mucosa of patients with FD-P were significantly (p<0.001 and p = 0.048, respectively) lower than those in patients with ECP. Although serum trypsin levels in ECP and FD-P patents were significantly (p<0.05 and p<0.001, respectively) associated with duodenal eosinophils counts, elevated trypsin levels were not significantly associated with degranulated eosinophils, occludin, claudin-1 and ZO-1 expression levels in the duodenum of either group. PAR2 mRNA levels were increased in the duodenum of patients with ECP and FD-P. PAR2 was localized in the epithelial cells of the duodenal mucosa and the surface of degranulated eosinophils in ECP and FD-P patients. Conclusions Elevated trypsin levels might be partly associated with duodenal inflammatory responses through PAR2-related degranulated eosinophils and the reduction of occludin in patients with ECP and FD-P.

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“…Dyspepsia refers to upper abdominal discomfort or indigestion with a prevalence of approximately 20% in general population. 1 Although the symptoms of patients with exocrine pancreatic dysfunction reportedly overlap with those of dyspepsia 2,3 and several studies demonstrating abnormal pancreatic function in patients with dyspepsia, [4][5][6][7][8] there are no available data to explain the direct relationships and linkages between pancreatic enzyme abnormalities and dyspeptic symptoms. We previously reported that pancreatic enzyme abnormalities occur concomitantly in patients with refractory functional dyspepsia (FD).…”

Section: Introductionmentioning

confidence: 99%

Combination of high‐density cholesterol level, elastic score, and severity of exocrine pancreatic dysfunction may be useful for a predictive factor for patients with early chronic pancreatitis

Agawa

Futagami

Watanabe

et al. 2022

J of Gastro and Hepatol

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Background: This study aimed to clarify whether any risk factors including clinical characteristics, endosonographic features, and exocrine pancreatic dysfunction may be useful for a predictive factor for patients with early chronic pancreatitis. Methods: A total of 163 consecutive patients that presented with functional dyspepsia with pancreatic enzyme abnormalities (FD-P) (n = 46), early chronic pancreatitis (ECP) (n = 47), and asymptomatic patients with pancreatic enzyme abnormalities (AP-P) (n = 70) based on the Rome III classification and the Japan Pancreatic Association were included in this study. The enrolled patients were evaluated using endosonography (EUS) and EUS elastography. The levels of the five pancreatic enzymes were measured. Pancreatic exocrine function was analyzed using N-benzoyl-l-tyrosyl-p-aminobenzoic acid (BT-PABA). Results: There were no significant differences in clinical characteristics such as age, gender, body mass index, alcohol consumption, and smoking among patients with AP-P, FD-P, and ECP. The ratio of BT-PABA test less than 35% in patients with ECP was significantly (P = 0.043) higher than in AP-P patients. Elastic score was a useful tool to differentiate the FD-P group from the ECP group. The high-density cholesterol levels in patients with ECP were significantly lower than those in AP-P. In addition, the combination of total and high-density cholesterol levels, BT-PABA test, and elastic score has a higher area under the curve value (0.708) of patients with ECP than in the other groups. Conclusions: The combination of high-density cholesterol levels, elastic score, and severity of exocrine pancreatic dysfunction may be useful for a predictive factor for patients with ECP.

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Exocrine pancreatic function and chronic unexplained dyspepsia

Cited by 19 publications

References 18 publications

To investigate possible etiologic factors of organic and functional dyspepsia in Turkey

To investigate possible etiologic factors of organic and functional dyspepsia in Turkey

Trypsin may be associated with duodenal eosinophils through the expression of PAR2 in early chronic pancreatitis and functional dyspepsia with pancreatic enzyme abnormalities

Combination of high‐density cholesterol level, elastic score, and severity of exocrine pancreatic dysfunction may be useful for a predictive factor for patients with early chronic pancreatitis

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