Digestive Disease Week location:Los Angeles date:20-25 May 2006
Background: Recent studies have shown that functional dyspepsia (FD) may persist after an acute gastroenteritis, and that post-infectious (PI) origin may be present in up to 20% of FD patients. The aim of this study was to evaluate the long-term prognosis of PI-FD and to identify factors influencing outcome. Methods: FD patients of presumed PI origin (acute onset with symptoms suggestive of infection) were prospectively followed and evaluated by telephone interview and mailed questionnaires. Patients underwent a full pathophysiological investigation (gastric emptying, barostat, H.pylori status) at inclusion, and follow-up data included FD symptom status, changes in body weight, quality of life (using NDI questionnaire) and trait and state anxiety and depression (using STAI and HADS). Correlation of these characteristics to FD status was assessed using Chi-square, parametrical or non-parametrical tests, and logistic regression. Results: Ninety-four PI-FD patients (mean age 46.1±1.4 y, 66 women), with a mean weight loss at presentation of 7.0±0.8 kg were recruited. After a mean follow-up of 63±3 months, FD symptoms had resolved in 30% of the patients. There was an increase in weight of 3.0±1.1 kg during follow-up, resulting in a residual net loss of 3.5±1.1 kg compared to symptom onset. Persisting FD symptoms during long-term follow-up were not influenced by any of the pathophysiological variables assessed, but were significantly associated with body weight at presentation and STAI scores. FD symptom status was also significantly associated with the NDI and the HADS-depression and -anxiety scores. In multivariate logistic regression, only STAI-trait was significantly associated with long-term FD outcome. Conclusion: Five years after the onset PI-FD, the majority of patients are still symptomatic and body weight has not fully recovered. Persisting symptoms are highly associated with a decreased quality of life, anxiety and depression. Trait anxiety is the main determinant of outcome of long-term prognosis in PI-FD.