Functional dyspepsia (FD) is categorized into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Acute gastroenteritis and Helicobacter pylori (HP) infection are known risk factors for FD. However, it is not clearly understood how these risk factors relate to Rome IV subgroups and their clinical impact.

A study looked at the association of postinfectious FD (PI-FD) and HP status with clinical profiles and weight loss. It enrolled consecutive FD patients who were evaluated for symptom frequency and severity. Patients were categorized as PDS, EPS or overlap group, based on severity scores. PI history and HP status were assessed for the patients.

• In this cohort of 459 FD patients, 36% had PDS, 9% were identified as having EPS and 55% had overlap.
• PI onset and positive HP status were reported by 20% and 14% patients, respectively, and did not differ significantly between the subgroups.
• Weight loss was evident in 63% of PDS, 36% of EPS and 56% of overlap patients.
• Early satiety severity was correlated with more severe weight loss in the PDS and overlap group.
• PI-FD patients had a higher likelihood of experiencing weight loss (OR 2.27).
• HP status had no significant correlation with weight loss.

Postinfectious onset of FD symptoms appeared to be a risk factor for weight loss; however, it was not associated with the symptom patterns of PDS, EPS or overlap subgroups.

Patients with HP infection did not have a higher likelihood of experiencing important weight loss.

Source: Schol J, Carbone F, Holvoet L, et al. Postinfectious onset in functional dyspepsia is a risk factor for weight loss. J Gastroenterol. 2022 Jan 29.