The brain–gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study

Koloski, Natasha A.; Jones, Michael; Kalantar, Jamshid S.; Weltman, Martin; Zaguirre, Jessa; Talley, Nick

doi:10.1136/gutjnl-2011-300474

Cited by 496 publications

(451 citation statements)

References 46 publications

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“…The incidence of functional dyspepsia is estimated to be 4-5% over a 10-year period 22,17 , with a similar rate of disappearance; disappearance could be due to spontaneous or therapy-induced remission but could also be temporary at the time of assessment 23 . That the prevalence of functional dyspepsia is higher among women than men is well established 24 , although in functional dyspepsia this difference is less prominent than in IBS.…”

Section: Epidemiologymentioning

confidence: 99%

“…The high prevalence of psychiatric comorbidity in functional dyspepsia 18 , another shared feature with IBS, has generated the hypothesis of a psychiatric origin of the disease, but long-term data indicate that this causeeffect correlation could go both ways: anxiety can increase the risk of future and new-onset functional dyspepsia 38 , and functional dyspepsia without psychiatric comorbidity at baseline can predict higher anxiety and depression scores at follow-up 22 . In an Australian cohort of 1,900 patients with IBS and/or functional dyspepsia, the diagnosis of depression and anxiety preceded that of a functional disorder in one-third of patients, whereas a functional disorder was diagnosed before the mood disorder in the other two-thirds 39 .…”

Section: Epidemiologymentioning

confidence: 99%

“…Although psychopathology can be a consequence of chronic gastrointestinal symptom burden 22,39 and predicts health care-seeking behaviour 123 and reduced QOL 124,125 (see below), its role in the aetio logy and pathophysiology of functional dyspepsia is unequivocally broader 33,120,121,126 . Several prospective studies 22,38,39,127 support a causal role of anxiety and/or depression in the aetiology, with recent findings suggest ing differences according to the functional dyspepsia subgroup 128 . However, bi-directional interactions between chronic symptom burden and psychosocial factors are assumed to occur in all functional gastrointestinal disorders as well as in other medical conditions associated with chronic physical symptoms, especially pain.…”

Section: Psychosocial Factors and Brain Mechanismsmentioning

confidence: 99%

“…This argument is also supported by the observation that patients with functional dyspepsia might eventually present with IBS symptoms at follow-up, whereas others with IBS might switch to functional dyspepsia after 2-10 years 16,17 . Functional dyspepsia overlaps not only with IBS and other functional gastrointestinal disorders but also with some somatic diseases and functional non-intestinal diseases, such as fibromyalgia, overactive bladder and chronic pelvic pain 18-21 .The incidence of functional dyspepsia is estimated to be 4-5% over a 10-year period 22,17 , with a similar rate of disappearance; disappearance could be due to spontaneous or therapy-induced remission but could also be temporary at the time of assessment 23 . That the prevalence of functional dyspepsia is higher among women than men is well established 24 , although in functional dyspepsia this difference is less prominent than in IBS.…”

mentioning

confidence: 99%

“…However, for example, in the case of gastroenteritis, none of these risk factors can currently determine whether the resulting disease will predominantly occur in the upper or lower gastro intestinal tract 36 or in the gastrointestinal tract at all 21 . In the case of gastrointestinal infections, one hypothesis suggests that the extent of intestinal inflammation after the infection can determine the phenotype 37 .The high prevalence of psychiatric comorbidity in functional dyspepsia 18 , another shared feature with IBS, has generated the hypothesis of a psychiatric origin of the disease, but long-term data indicate that this causeeffect correlation could go both ways: anxiety can increase the risk of future and new-onset functional dyspepsia 38 , and functional dyspepsia without psychiatric comorbidity at baseline can predict higher anxiety and depression scores at follow-up 22 . In an Australian cohort of 1,900 patients with IBS and/or functional dyspepsia, the diagnosis of depression and anxiety preceded that of a functional disorder in one-third of patients, whereas a functional disorder was diagnosed before the mood disorder in the other two-thirds 39 .…”

mentioning

confidence: 99%

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Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

260

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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