Increased visceral sensitivity, elevated anxiety, and depression levels in patients with functional esophageal disorders and non‐erosive reflux disease

Losa, Marco; Manz, Salomon; Schindler, Valeria; Savarino, Edoardo; Pohl, Daniel

doi:10.1111/nmo.14177

Cited by 22 publications

(14 citation statements)

References 39 publications

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“…In the investigation of GORD pathogenesis, anxious feeling and depression might also be implicated in a similar pattern. GORD may be exacerbated by anxious feeling and depression by reducing the visceral sensitivity index (VSI), enhancing reflux hypersensitivity, and functional heartburn ( 54 ). Our study further highlighted the independent causalities of anxious feeling and depression on the risk of GORD.…”

Section: Discussionmentioning

confidence: 99%

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Sun

Cao²,

Cao³

et al. 2022

Front. Nutr.

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BackgroundGastro-oesophageal reflux disease (GORD) is a common gastrointestinal dysfunction that significantly affects the quality of daily life, and health interventions are challenging to prevent the risk of GORD. In this study, we used Mendelian randomization framework to genetically determine the causal associations between multifaceted modifiable factors and the risk of GORD.Materials and methodsSixty-six exposures with available instrumental variables (IVs) across 6 modifiable pathways were included in the univariable MR analysis (UVMR). Summary-level genome-wide association studies (GWAS) datasets for GORD were retrieved from the Neale Lab (GORDNeale, Ncases = 29975, Ncontrols = 390556) and FinnGen (GORDFinn, Ncases = 13141, Ncontrols = 89695). Using the METAL software, meta-analysis for single nucleotide polymorphisms (SNPs) from GORDNeale and GORDFinn was conducted with an inverse variance weighted (IVW) fixed-effect model. Moreover, we leveraged partition around medoids (PAM) clustering algorithm to cluster genetic correlation subtypes, whose hub exposures were conditioned for multivariable MR (MVMR) analyses. P-values were adjusted with Bonferroni multiple comparisons.ResultsSignificant causal associations were identified between 26 exposures (15 risk exposures and 11 protective exposures) and the risk of GORD. Among them, 13 risk exposures [lifetime smoking, cigarette consumption, insomnia, short sleep, leisure sedentary behavior (TV watching), body mass index (BMI), body fat percentage, whole body fat mass, visceral adipose tissue, waist circumference, hip circumference, major depressive disorder, and anxious feeling], and 10 protective exposures (leisure sedentary behavior (computer use), sitting height, hand grip strength (left and right), birth weight, life satisfaction, positive affect, income, educational attainment, and intelligence) showed novel significant causal associations with the risk of GORD. Moreover, 13 exposures still demonstrated independent associations with the risk of GORD following MVMR analyses conditioned for hub exposures (educational attainment, smoking initiation and BMI). In addition, 12 exposures showed suggestive causal associations with the risk of GORD.ConclusionThis study systematically elucidated the modifiable factors causally associated with the risk of GORD from multifaceted perspectives, which provided implications for prevention and treatment of GORD.

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Section: Discussionmentioning

confidence: 99%

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Sun

Cao²,

Cao³

et al. 2022

Front. Nutr.

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show abstract

“…For example, in patients with gastroesophageal reflux, there is a strong correlation between anxiety and depression as well as gastrointestinal symptoms, such as gastric mucosal erosion. Furthermore, psychological or antidepressant treatment is effective for some patients [ 95 , 96 ]. In psychiatric patients, depression and generalized anxiety disorder are often accompanied by gastrointestinal discomfort [ 97 ], and many patients with generalized anxiety disorder are often first diagnosed with a gastro-enterologic issue [ 98 ].…”

Section: Changes Of Intestinal Flora Are Closely Related To Post-stro...mentioning

confidence: 99%

Ischemic stroke and intestinal flora: an insight into brain–gut axis

Kong

Wang

et al. 2022

Eur J Med Res

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Stroke is a type of cerebrovascular disease that significantly endangers human health and lowers quality of life. This understandably places a heavy burden on society and families. In recent years, intestinal flora has attracted increasing attention from scholars worldwide, and its association with ischemic stroke is becoming a hot topic of research amongst researchers in field of stroke. After suffering from a stroke, intestinal microbial dysbiosis leads to increased intestinal permeability and activation of the intestinal immune system, which in turn leads to ectopic intestinal bacteria and pro-inflammatory cells that enter brain tissue through the damaged blood-brain barrier. This exacerbates ischemia-reperfusion injury. Interestingly, after a stroke, some metabolites produced by the intestinal flora attenuate ischemia-reperfusion injury by suppressing the post-stroke inflammatory response and promotes the repair of neurological function. Here we elucidate the changes in gut flora after occurrence of a stroke and highlight the immunomodulatory processes of the post-stroke gut flora.

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“…Interestingly, small intestinal visceral sensory threshold, while lowered in FGID patients, is not different between FD and IBS 40 . While heartburn in patients with non‐erosive reflux disease might be due to altered sensory function, 41 alterations of sensory function may explain the overlap of heartburn/FD/IBS.…”

Section: Discussionmentioning

confidence: 99%

Overlap of heartburn, functional dyspepsia, and irritable bowel syndrome in a population sample: Prevalence, temporal stability, and associated comorbidities

Jones

Shah

Walker

et al. 2022

Neurogastroenterology Motil

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Background: Co-occurring (overlapping) irritable bowel syndrome (IBS), functional dyspepsia (FD), and heartburn has been observed. However, whether it is a distinct entity has not been established, nor what clinical, demographic, lifestyle, and psychological traits are associated with it. This study sought to estimate the prevalence and temporal stability of this overlap and to identify features specific to it in order to gain some insights into the potential etiopathogenesis.Methods: Two waves of a survey to a population-representative sample were conducted 3 years apart, recruiting 1312 individuals for this study. The chanceexpected probability of complete overlap (CO) was calculated and compared with the observed CO. A range of demographic, lifestyle factors, medical diagnoses, sleep quality, and psychological distress were tested to identify predictors of overlap using logistic regression. Key Results: CO was observed in 2.1% (95% confidence interval 1.9, 3.7) of the sample and was closely replicated in wave 2 at 2.0%. The observed CO was greater than expected by chance (0.2%) to a statistically significant extent (p < 0.001). Overlap between IBS subtypes, FD subtypes, and heartburn was also elevated above chance expectation. Individuals with CO were separately differentiated from others with respect to elevated rates of self-reported medically diagnosed asthma, elevated psychological distress score, and elevated impact on sleep quality. The discrimination provided by these factors was further independent of age and sex. Conclusions and Inferences: Overlap between IBS, FD, and heartburn (GERD)appears to be a distinct entity that has a profile including psychological morbidity, sleep disturbance, and elevated rates of atopy.

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Increased visceral sensitivity, elevated anxiety, and depression levels in patients with functional esophageal disorders and non‐erosive reflux disease

Cited by 22 publications

References 39 publications

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Ischemic stroke and intestinal flora: an insight into brain–gut axis

Overlap of heartburn, functional dyspepsia, and irritable bowel syndrome in a population sample: Prevalence, temporal stability, and associated comorbidities

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