-Original-

Impact of Coexisting Irritable Bowel Syndrome and Non-erosive Reflux Disease on Postprandial Abdominal Fullness and Sleep Disorders in Functional Dyspepsia

Seiji Futagami, Hiroshi Yamawaki, Mayumi Shimpuku, Nikki Izumi, Taiga Wakabayashi, Yasuhiro Kodaka, Hiroyuki Nagoya, Tomotaka Shindo, Tetsuro Kawagoe and Choitsu Sakamoto

Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School

Background/Aims: The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail.
Methods: The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the ¹³C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores.
Results: There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone.
Conclusion: Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

J Nippon Med Sch 2013; 80: 362-370

Keywords
functional dyspepsia, gastric motility, sleep disorders, overlap syndrome

Correspondence to
Seiji Futagami, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
seiji.futagami@gmail.com

Received, December 6, 2012
Accepted, July 17, 2013