TY - JOUR
T1 - Prevalence, symptoms and risk factor profile of rumination syndrome and functional dyspepsia
T2 - a population-based study
AU - Zand Irani, Mudar
AU - Jones, Michael P.
AU - Halland, Magnus
AU - Herrick, Linda
AU - Choung, Rok Seon
AU - Saito Loftus, Yuri A.
AU - Walker, Marjorie M.
AU - Murray, Joseph A.
AU - Talley, Nicholas J.
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85116569571&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85116569571&partnerID=8YFLogxK
U2 - 10.1111/apt.16630
DO - 10.1111/apt.16630
M3 - Article
C2 - 34626489
AN - SCOPUS:85116569571
SN - 0269-2813
VL - 54
SP - 1416
EP - 1431
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
IS - 11-12
ER -