Department of Gastroenterology, Neurogastroenterology & Motility, Translational Research in GastroIntestinal Disorders (TARGID), University of Leuven, Leuven, Belgium.
Barts and The London School of Medicine and Dentistry, Wingate Institute of Neurogastroneterology, Centre for Neuroscience and Trauma, Blizard Institute Queen Mary University of London UK, London, United Kingdom.
Clin Transl Gastroenterol. 2020 Nov;11(11):e00220. doi: 10.14309/ctg.0000000000000220.
The pathophysiology underlying functional dyspepsia (FD) is multifactorial and focuses on gastric sensorimotor dysfunction. Recent studies demonstrated that joint hypermobility syndrome (JHS) is strongly associated with unexplained dyspeptic symptoms in patients attending gastrointestinal clinics. We aimed to study the relationship between symptoms, gastric sensorimotor function, and JHS in FD patients.
Tertiary care FD patients who underwent a gastric barostat study and a gastric emptying breath test with 13C-octanoic acid were recruited for assessment of JHS. The presence of JHS was evaluated by a 2-phase interview and clinical examination that included major and minor criteria of the Brighton classification.
A total of 62 FD patients (68% women, age 44 ± 1.8 years, and body mass index: 21.7 ± 0.7 kg/m) accepted to participate in the study. JHS was diagnosed in 55% of FD patients. Assessed symptom profiles during the visit did not differ between the groups. Delayed gastric emptying was not significantly more common in JHS group compared with non-JHS group (JHS group 32% vs non-JHS group 16%, P = 0.31). Prevalence of hypersensitivity to distention (JHS group 24% vs non-JHS group 29%, P = 0.76) and impaired gastric accommodation (JHS group 38% vs non-JHS group 42%, P = 0.79) was similar in patients with or without JHS. No correlations were found between the Beighton hypermobility score and gastric compliance (r = 0.09).
A large subset of this study cohort of tertiary care FD patients has coexisting JHS. We did not identify any specific differences in gastric sensorimotor function between patients with and without JHS. Further prospective research will be required to elucidate the relationship between JHS, a multisystemic disorder with widespread manifestations, and FD symptoms.
功能性消化不良(FD)的病理生理学是多因素的,侧重于胃感觉运动功能障碍。最近的研究表明,关节过度活动综合征(JHS)与胃肠诊所就诊的不明原因消化不良症状密切相关。我们旨在研究 FD 患者症状、胃感觉运动功能与 JHS 之间的关系。
招募接受胃测压和 13C-辛酸呼气试验的三级保健 FD 患者进行 JHS 评估。JHS 的存在通过两阶段访谈和临床检查进行评估,包括 Brighton 分类的主要和次要标准。
共有 62 名 FD 患者(68%为女性,年龄 44 ± 1.8 岁,体重指数 21.7 ± 0.7 kg/m)接受了研究。55%的 FD 患者诊断为 JHS。就诊时评估的症状谱在两组之间没有差异。与非 JHS 组相比,JHS 组的胃排空延迟并不常见(JHS 组 32%比非 JHS 组 16%,P = 0.31)。JHS 组对扩张的超敏反应(JHS 组 24%比非 JHS 组 29%,P = 0.76)和胃顺应性受损(JHS 组 38%比非 JHS 组 42%,P = 0.79)的发生率在 JHS 患者和非 JHS 患者之间相似。Beighton 运动过度评分与胃顺应性之间无相关性(r = 0.09)。
本研究队列的大量三级保健 FD 患者存在共存的 JHS。我们没有发现 JHS 患者与非 JHS 患者之间胃感觉运动功能有任何特定差异。需要进一步的前瞻性研究来阐明 JHS 这一多系统疾病与广泛表现与 FD 症状之间的关系。