- Title
- Functional dyspepsia is associated with duodenal eosinophilia in an Australian paediatric cohort
- Creator
- Wauters, L.; Nightingale, S.; Talley, N. J.; Sulaiman, B.; Walker, M. M.
- Relation
- Alimentary Pharmacology and Therapeutics Vol. 45, Issue 10, p. 1358-1364
- Publisher Link
- http://dx.doi.org/10.1111/apt.14045
- Publisher
- Wiley-Blackwell
- Resource Type
- journal article
- Date
- 2017
- Description
- Background: The pathophysiology of functional dyspepsia (FD) remains unknown. Duodenal eosinophil infiltration has been reported. Aim: To assess the association between dyspeptic symptoms and duodenal eosinophilia in children undergoing upper gastrointestinal endoscopy. Methods: In this retrospective cohort study, children with normal upper endoscopy and routine histology at a single tertiary paediatric centre between 2010 and 2014 were included. FD was defined as epigastric pain or discomfort > 2 months without response to acid suppression. Controls presented with nonerosive reflux disease, dysphagia or rumination syndrome. Intramucosal eosinophil counts were compared between the groups using uni- and multivariate regression analyses. Results: Thirty-six cases and 36 nonmatched controls were identified. Atopic history (39% vs. 25%) and psychological comorbidity (53% vs. 39%; both P = 0.2) were frequent in cases and controls. Self-reported nausea (64% vs. 17%; P < 0.0001), lethargy (19% vs. 0%; P = 0.005) and family functional gastrointestinal disorder(FGID) (28% vs. 3%; P = 0.003) were more common in cases than controls. Duodenal eosinophil counts [median (IQR): 151 (118-207) vs. 76 (60-106) per mm²; P < 0.001] were significantly higher in cases than controls with > 112 eosinophils per mm² predictive for FD (OR: 33.6, 95% CI: 7.1-159.0; P < 0.001). Duodenal eosinophilia was associated with weight loss (OR: 7.1, 95% CI: 1.1-45.5; P = 0.04). Conclusions: Functional dyspepsia in children is strongly associated with duodenal eosinophilia, in the absence of endoscopic or routine histological findings. Frequent atopic and psychological comorbidity illustrate likely multifactorial mechanisms.
- Subject
- dyspepsia; functional dyspepsia; duodenal eosinophilia; upper gastrointestinal endoscopy; Australia; children
- Identifier
- http://hdl.handle.net/1959.13/1399596
- Identifier
- uon:34641
- Identifier
- ISSN:0269-2813
- Language
- eng
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