State of anxiety may be associated with exocrine pancreatic insufficiency in functional dyspepsia patients with pancreatic enzyme abnormalities

Shuhei Agawa; Seiji Futagami; Hiroshi Yamawaki; Katya Gudis; Kazutoshi Higuchi; Keiko Kaneko; Mayu Habiro; Yasuhiro Kodaka; Nobue Ueki; Yoshiyuki Watanabe; Norio Motoda; Ryuji Ohashi; Katsuhiko Iwakiri

doi:10.3164/jcbn.21-67

Original Articles

State of anxiety may be associated with exocrine pancreatic insufficiency in functional dyspepsia patients with pancreatic enzyme abnormalities

Shuhei Agawa, Seiji Futagami, Hiroshi Yamawaki, Katya Gudis, Kazutoshi Higuchi, Keiko Kaneko, Mayu Habiro, Yasuhiro Kodaka, Nobue Ueki, Yoshiyuki Watanabe, Norio Motoda, Ryuji Ohashi, Katsuhiko Iwakiri

Author information

Shuhei Agawa
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Seiji Futagami
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Hiroshi Yamawaki
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Katya Gudis
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Kazutoshi Higuchi
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Keiko Kaneko
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Mayu Habiro
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Yasuhiro Kodaka
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Nobue Ueki
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
Yoshiyuki Watanabe
Division of Gastroenterology, St. Marianna University School of Medicine
Norio Motoda
Division of Pathology, Department of Internal Medicine, Nippon Medical School
Ryuji Ohashi
Division of Pathology, Department of Internal Medicine, Nippon Medical School
Katsuhiko Iwakiri
Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School

Keywords: functional dyspepsia, exocrine pancreatic insufficiency, pancreatic enzyme abnormalities, state of anxiety

JOURNAL FREE ACCESS

2022 Volume 70 Issue 2 Pages 175-181

DOI https://doi.org/10.3164/jcbn.21-67

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Abstract

We have reported that refractory functional dyspepsia patients with pancreatic enzyme abnormalities (FD-P). We tried to analyze the prevalence of exocrine pancreatic insufficiency (EPI) in FD-P patients to clarify whether the pathophysiology of FD patients including clinical symptoms and quality of life were associated with EPI. We enrolled forty-nine patients presenting with typical symptoms of FD-P patients (n = 20) and asymptomatic patients with pancreatic enzyme abnormalities (AP-P) (n = 29). Five pancreatic enzymes (p-amylase, lipase, elastase-1, trypsin, and PLA2) were measured and STAI-state/-trait and SF-8 were evaluated. Pancreatic exocrine function was analyzed using N-benzoyl-l-tyrosyl-p-aminobenzoic acid (BT-PABA). There were no significant differences in patient background between FD-P and AP-P patients. BT-PABA test scores for FD-P patients (61.67 ± 5.55) were significantly (p = 0.01) lower than in AP-P patients (95.38 ± 2.36). Physical component scale (PCS) in FD-P patients was significantly (p = 0.002) lower than that in AP-P patients. STAI-state was relatively (p = 0.054) associated with BT-PABA test in FD-P and AP-P patients by multiple logistic regression analysis. The prevalence of EPI in FD-P patients was significantly higher than that in AP-P patients and was relatively associated with state of anxiety. Further studies will be needed to clarify how EPI or pancreatic enzyme abnormalities are associated with the pathophysiology of FD-P patients.

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