The Associations Between Acid-Suppressive Drug Intake and Symptom Profiles in Functional Dyspepsia Patients Referred for Open-Access Endoscopy.

BACKGROUND

Functional dyspepsia (FD) is characterised by postprandial fullness, early satiation, epigastric pain, or burning without structural abnormalities on upper endoscopy. Proton pump inhibitors (PPIs) are the preferred first-line therapy. Given that the diagnosis of FD is largely based on symptom assessment, it remains unclear whether acid-suppression meaningfully influences symptom presentation.

OBJECTIVE

This exploratory study aimed to determine the prevalence of acid-suppressive therapy (PPIs or H2 receptor antagonists (H2RAs)) among FD patients and to compare symptom patterns between patients with and without these treatments.

METHODS

In this single-centre, cross-sectional observational study, ambulatory patients referred for diagnostic upper endoscopy completed the Waiting Room Questionnaire (WRQ). Endoscopic findings were recorded, and FD was defined using Rome IV. Acid-suppression was defined as self-reported use of PPIs or H2RAs. Symptom frequency was compared between patients on and off therapy.

RESULTS

1158 patients completed the WRQ; 27% fulfiled the criteria for FD. Among FD patients, 60% reported acid-suppressive therapy, similar to patients with endoscopic findings. FD patients receiving acid-suppression reported higher frequencies of early satiation (OR = 1.68, 95% CI 1.08-2.60), nausea (OR = 1.93, 95% CI 1.23-3.01), and epigastric pain (OR = 1.74, 95% CI 1.12-2.69). In subgroup analyses, therapy was associated with more frequent epigastric burning in postprandial distress syndrome (OR = 3.81, 95% CI 1.50-9.67) and higher frequencies of postprandial fullness (OR = 2.90, 95% CI 1.24-6.80) and early satiation (OR = 2.34, 95% CI 1.13-4.85) in the overlap subgroup.

CONCLUSIONS

FD is prevalent in open-access endoscopy, and acid-suppressive therapy is frequently used in this population. FD patients receiving acid-suppression reported slightly higher frequencies of several symptoms, highlighting the need to further explore these associations.