P0613 - Risk of Barrett’s Esophagus in Patients With Functional Dyspepsia: A Multi-Center Retrospective Cohort Study

Muhammad Hassaan Arif Maan, MD¹, Soban Maan, MD², Imran A. Qureshi, MD³, Yazan Abboud, MD³, Wajiha Khan, MD⁴, Muhammad Mursaleen Ahmad, MBBS⁵, Muhammad Waleed, MD^2
1Rutgers New Jersey Medical School, Bloomfield, NJ; ²West Virginia University, Morgantown, WV; ³Rutgers New Jersey Medical School, Newark, NJ; ⁴Rutgers New Jersey Medical School, Cartaret, NJ; ⁵Punjab Institute of Medical Sciences, Bloomfield, NJ

Introduction: Dyspepsia refers to a set of gastroduodenal symptoms such as epigastric pain or burning, postprandial fullness, or early satiety. Most dyspepsia cases do not have an underlying structural explanation for the symptoms and are attributed to functional dyspepsia (FD). Whereas evidence of gastritis on endoscopy and its association with esophageal dysplasia is well-studied, data about the association between FD and the risk of developing esophageal metaplasia/dysplasia is scarce.

Methods: We performed a multi-center cohort study using an electronic health records-based research network, TriNetX to assess the association of FD and Barrett’s Esophagus (BE). 1:1 propensity score matching was used to match patients with the diagnosis of FD between January 1, 2006, and December 31, 2022, with those without FD diagnosis (control) to minimize confounding. Patients who had diagnoses of BE or esophageal cancer before the study period were excluded. Both groups were matched for age, gender, race, ethnicity, elevated body mass index, smoking, alcohol use, gastroesophageal reflux disease (GERD), and proton pump inhibitor (PPI) use at baseline. We used the diagnosis of BE as our primary outcome. Hazard ratios (HRs) with their corresponding 95% confidence intervals were calculated. As GERD and BE can be silent and may remain undetected, we employed sensitivity analysis to specifically compare outcomes in patients who had undergone esophagogastroduodenoscopy (EGD) after being included in the study.

Results: After 1:1 propensity matching, each cohort had 416,455 patients. The cohorts were adequately balanced with a standard mean difference (SMD) ≤ 0.1 for all selected covariates (Table 1). Mean (SD) duration of follow-up was 5.1 (4.3) years for the study cohort and 10.1 (6.4) years for the control cohort. The FD cohort was observed to have a significantly higher risk of BE (HR: 1.924, 95% CI: 1.84,2.012, Log-rank p: < 0.001) and Barrett’s-associated dysplasia (HR: 3.491, 95% CI: 3.026,4.027, Log-rank p: < 0.001). These findings remained unchanged in sensitivity analysis.

Discussion: Despite the absence of structural pathology at the time of diagnosis, people with functional dyspepsia are pre-disposed to an increased risk of developing esophageal metaplasia/dysplasia. This warrants close follow-up and frequent re-evaluation of symptomatology to assess the need for diagnostic/therapeutic interventions.


Disclosures:


Muhammad Hassaan Arif Maan, MD¹, Soban Maan, MD², Imran A. Qureshi, MD³, Yazan Abboud, MD³, Wajiha Khan, MD⁴, Muhammad Mursaleen Ahmad, MBBS⁵, Muhammad Waleed, MD². P0613 - Risk of Barrett’s Esophagus in Patients With Functional Dyspepsia: A Multi-Center Retrospective Cohort Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.