Gender Difference in Functional Gastrointestinal Disorders / 대한소화기학회지

Functional gastrointestinal diseases (FGIDs) are known to be influenced more by a lowering of the quality of life, such as mental health and sleep quality, compared to organic diseases. Genetic, microbiological, molecular biological, and social environmental factors are involved in the pathophysiology of FGIDs. In particular, mental factors, such as depression and anxiety, play a major role in the development of FGIDs. The prevalence of most FGIDs is higher in women. Gender needs to be analyzed in patients with FGIDs because it can have a great influence on the onset of FGIDs. Because there are differences in the treatment response according to gender, further research in the development of therapeutic drugs considering this gender difference will be needed, and ultimately it will be possible to lower the prevalence of FGIDs and improve the quality of life of patients.

Overlap of Erosive and Non-erosive Reflux Diseases With Functional Gastrointestinal Disorders According to Rome III Criteria

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is increasing in Asian countries. Functional dyspepsia (FD) or irritable bowel syndrome (IBS) are also prevalent and commonly overlapped with GERD. This study was conducted to compare the proportion and risk factors for overlapping reflux esophagitis (RE) and non-erosive reflux disease (NERD) with functional gastrointestinal disorders (FGIDs). METHODS: A total of 2,388 [male, 55.9%; mean age (+/- SD), 43.2 years (+/- 8.4)] Korean subjects who underwent the upper endoscopy for health screening were prospectively included. The subjects were asked about demographic, medical and social history by using a structured questionnaire, and FD and IBS were assessed according to the Rome III criteria. RESULTS: The subjects with RE were 286 (12.0%, male 88.5%, 42.8 years) and 74 subjects had NERD (3.1%) while the prevalence of FD and IBS were 8.1% and 10.1%, respectively. The proportion of FD and IBS in NERD was higher than that of RE (74.3% vs. 10.5%, p = 0.000; 41.9% vs. 11.2%, p = 0.000, respectively). The epigastric pain syndrome (EPS) was more prevalent than postprandial distress syndrome in NERD. According to multiple regression analysis, high somatization score and the presence of FD increased the odd ratio for NERD. However, male gender and current smoker were significant risk factors for RE. CONCLUSIONS: Compared to RE, NERD is more frequently overlapped with FD, especially EPS, and also are associated with significantly increased frequency of IBS. Our data draws attention to the possibility of subgrouping FGIDs and GERD to be important in understanding the pathophysiology of these conditions.

Association of CCK1 Receptor Gene Polymorphisms and Irritable Bowel Syndrome in Korean

INTRODUCTION: Cholecystokinin (CCK) belongs to a group of endogenous molecules known as brain-gut neuropeptides and functions as a neuropeptide as well as a gut hormone. It remains unclear whether genetic variation of the CCK receptor plays a role in irritable bowel syndrome (IBS). The aim of this study was to determine and compare the allele and genotype frequencies of the CCK1 receptor polymorphisms between healthy controls and patients with IBS. METHODS: Genotyping of 80 patients with IBS (who met the Rome III criteria) and 76 healthy controls was performed. We performed PCR amplification for the CCK1 receptor intron 1 779 T > C and Exon 1 G > A. We confirmed polymorphisms by direct sequencing method. RESULTS: There was a significantly different trend for genotypic distributions of the CCK1 receptor polymorphism between patients with IBS and healthy controls (p for trend = 0.048). The CCK1 receptor intron 1 779 T >C polymorphic type was more common in patients with 'IBS-constipation predominant (IBS-C) and IBS-mixed (IBS-M) forms' (19/31, 61.3%) than healthy controls 32/76, 42.1% adjusted odd ratio 2.43, 95% Confidence interval 1.01-5.86). The genotypic distributions of the CCK1 receptor exon 1 polymorphism were not significantly different between the two groups (p for trend = 0.223). CONCLUSIONS: CCK1 receptor polymorphisms were associated with IBS. In particular, the CCK1 receptor intron 1 779 T > C polymorphic type was associated with 'IBS-C and IBS-M'. Further studies are needed in larger number of patients with an even distribution of IBS subtypes.