Prevalence, symptoms and risk factor profile of rumination syndrome and functional dyspepsia: a population-based study.


Journal

Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234

Informations de publication

Date de publication:
12 2021
Historique:
revised: 26 08 2021
received: 13 08 2021
accepted: 21 09 2021
pubmed: 10 10 2021
medline: 16 11 2021
entrez: 9 10 2021
Statut: ppublish

Résumé

Rumination syndrome is a functional gastroduodenal disorder characterised by effortless regurgitation of recently ingested food. Emerging evidence reports duodenal eosinophilic inflammation in a subset, suggesting a shared pathophysiology with functional dyspepsia (FD). To assess the clinical features of rumination syndrome and FD in a community-based study. We mailed a survey assessing gastrointestinal symptoms, diet and psychological symptoms to 9835 residents of Olmsted County, MN, USA in 2017-2018; diagnostic codes were obtained from linked clinical records. The two disorders were assessed as mutually exclusive in 'pure' forms with a separate overlap group, all compared to a control group not meeting criteria for either. Prevalence of associations, and univariate and independent associations with predictors were assessed by logistic regression. Prevalence of rumination syndrome and FD were 5.8% and 7.1%, respectively; the overlap was 3.83-times more likely than expected by chance. Independent predictors for rumination (odds ratio (OR), 95% confidence interval (CI)) were female gender (1.79, 1.21-2.63), smoking (1.89, 1.28-2.78), gluten-free diet (1.58, 1.14-2.19), allergic rhinitis (1.45, 1.01-2.08) and depression (1.10, 1.05-1.16). FD was independently associated with female gender, depression, non-coeliac wheat sensitivity, migraine, irritable bowel syndrome and somatic symptoms. A similar reported efficacy (≥54%) of low fat or dairy-free diets was found with both disorders (P = 0.53 and P = 1.00, respectively). The strongest independent associations with overlapping FD and rumination syndrome were a history of rheumatoid arthritis (3.93, 1.28-12.06) and asthma (3.02, 1.44-6.34). Rumination syndrome overlaps with FD with a shared risk factor profile, suggesting a common pathophysiology.

Sections du résumé

BACKGROUND
Rumination syndrome is a functional gastroduodenal disorder characterised by effortless regurgitation of recently ingested food. Emerging evidence reports duodenal eosinophilic inflammation in a subset, suggesting a shared pathophysiology with functional dyspepsia (FD).
AIM
To assess the clinical features of rumination syndrome and FD in a community-based study.
METHODS
We mailed a survey assessing gastrointestinal symptoms, diet and psychological symptoms to 9835 residents of Olmsted County, MN, USA in 2017-2018; diagnostic codes were obtained from linked clinical records. The two disorders were assessed as mutually exclusive in 'pure' forms with a separate overlap group, all compared to a control group not meeting criteria for either. Prevalence of associations, and univariate and independent associations with predictors were assessed by logistic regression.
RESULTS
Prevalence of rumination syndrome and FD were 5.8% and 7.1%, respectively; the overlap was 3.83-times more likely than expected by chance. Independent predictors for rumination (odds ratio (OR), 95% confidence interval (CI)) were female gender (1.79, 1.21-2.63), smoking (1.89, 1.28-2.78), gluten-free diet (1.58, 1.14-2.19), allergic rhinitis (1.45, 1.01-2.08) and depression (1.10, 1.05-1.16). FD was independently associated with female gender, depression, non-coeliac wheat sensitivity, migraine, irritable bowel syndrome and somatic symptoms. A similar reported efficacy (≥54%) of low fat or dairy-free diets was found with both disorders (P = 0.53 and P = 1.00, respectively). The strongest independent associations with overlapping FD and rumination syndrome were a history of rheumatoid arthritis (3.93, 1.28-12.06) and asthma (3.02, 1.44-6.34).
CONCLUSION
Rumination syndrome overlaps with FD with a shared risk factor profile, suggesting a common pathophysiology.

Identifiants

pubmed: 34626489
doi: 10.1111/apt.16630
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1416-1431

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

© 2021 John Wiley & Sons Ltd.

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Auteurs

Mudar Zand Irani (M)

Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.
Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.

Michael P Jones (MP)

NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.
School of Psychological Sciences, Macquarie University, North Ryde, NSW, Australia.

Magnus Halland (M)

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Linda Herrick (L)

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Rok Seon Choung (RS)

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Yuri A Saito Loftus (YA)

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Marjorie M Walker (MM)

Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.

Joseph A Murray (JA)

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Nicholas J Talley (NJ)

Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
NHMRC Centre of Research Excellence in Digestive Health, New Lambton Heights, NSW, Australia.
Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.

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