Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study

Aim and background: Diabetes mellitus virtually affects every organ in the body. Gastrointestinal effects include small intestinal bacterial overgrowth (SIBO), gastrointestinal reflux disease, gastroparesis, neuropathy, pancreatopathy, and non-alcoholic fatty liver disease. Our study aimed to assess...

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Main Authors: Nidhi Bhutra, Ravi Kant, Itish Patnaik, Vandana K Dhingra
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2024-12-01
Series:Bengal Physician Journal
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Online Access:https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8071
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author Nidhi Bhutra
Ravi Kant
Itish Patnaik
Vandana K Dhingra
author_facet Nidhi Bhutra
Ravi Kant
Itish Patnaik
Vandana K Dhingra
author_sort Nidhi Bhutra
collection DOAJ
description Aim and background: Diabetes mellitus virtually affects every organ in the body. Gastrointestinal effects include small intestinal bacterial overgrowth (SIBO), gastrointestinal reflux disease, gastroparesis, neuropathy, pancreatopathy, and non-alcoholic fatty liver disease. Our study aimed to assess and identify various causes of dyspepsia in type 2 diabetes mellitus (DM) patients. Materials and methods: After screening the patients for inclusion and exclusion criteria, enrolled participants were subjected to a urea breath test (UBT), glucose hydrogen breath test (HBT), upper gastrointestinal endoscopy (UGIE), pancreatic fecal elastase (PEF), and gastric scintigraphy. Results: The study revealed that 42.5% of patients had positive UBT for <italic>H. pylori</italic> gastritis, while 37.5% had organic causes of dyspepsia. Pancreatic exocrine insufficiency (PEI) was present in 37.5% of patients, and slow gastric emptying in 12.5% suggested gastroparesis. There was significant negative correlation between HbA1c and pancreatic fecal elastase levels. In 26.8% of patients, no cause of dyspepsia could be identified, 34.2% had dyspepsia secondary to a single etiology; and 26.8% of patients had two underlying etiologies of dyspepsia. In contrast, the remaining had multiple causes of dyspepsia. Conclusion and clinical significance: The study identified multiple causes of dyspepsia in type 2 diabetic patients in India, with a large proportion having PEI. Further studies are needed to determine if pancreatic enzyme supplementation can alleviate dyspeptic symptoms. In conclusion, dyspepsia in diabetic patients can be attributed to multiple coexisting causes, necessitating etiology-directed management.
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spelling doaj-art-68b13ef0d84d45ff9a044b24c46484dc2025-08-20T03:17:26ZengJaypee Brothers Medical PublisherBengal Physician Journal2582-12022024-12-0111312012410.5005/jp-journals-10070-80717Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational StudyNidhi Bhutra0Ravi Kant1https://orcid.org/0000-0003-1144-4478Itish Patnaik2https://orcid.org/0000-0003-2726-3516Vandana K Dhingra3https://orcid.org/0000-0002-3006-8597Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, IndiaRavi Kant, Department of General Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, Phone: +91 9870717859Department of Gastroenterology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, IndiaDepartment of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, IndiaAim and background: Diabetes mellitus virtually affects every organ in the body. Gastrointestinal effects include small intestinal bacterial overgrowth (SIBO), gastrointestinal reflux disease, gastroparesis, neuropathy, pancreatopathy, and non-alcoholic fatty liver disease. Our study aimed to assess and identify various causes of dyspepsia in type 2 diabetes mellitus (DM) patients. Materials and methods: After screening the patients for inclusion and exclusion criteria, enrolled participants were subjected to a urea breath test (UBT), glucose hydrogen breath test (HBT), upper gastrointestinal endoscopy (UGIE), pancreatic fecal elastase (PEF), and gastric scintigraphy. Results: The study revealed that 42.5% of patients had positive UBT for <italic>H. pylori</italic> gastritis, while 37.5% had organic causes of dyspepsia. Pancreatic exocrine insufficiency (PEI) was present in 37.5% of patients, and slow gastric emptying in 12.5% suggested gastroparesis. There was significant negative correlation between HbA1c and pancreatic fecal elastase levels. In 26.8% of patients, no cause of dyspepsia could be identified, 34.2% had dyspepsia secondary to a single etiology; and 26.8% of patients had two underlying etiologies of dyspepsia. In contrast, the remaining had multiple causes of dyspepsia. Conclusion and clinical significance: The study identified multiple causes of dyspepsia in type 2 diabetic patients in India, with a large proportion having PEI. Further studies are needed to determine if pancreatic enzyme supplementation can alleviate dyspeptic symptoms. In conclusion, dyspepsia in diabetic patients can be attributed to multiple coexisting causes, necessitating etiology-directed management.https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8071cross-sectional observational studydyspepsiagastrointestinalhba1cpancreatic exocrine insufficiencypeptic ulcer diseasetype 2 diabetes mellitussmall intestinal bacterial overgrowth
spellingShingle Nidhi Bhutra
Ravi Kant
Itish Patnaik
Vandana K Dhingra
Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
Bengal Physician Journal
cross-sectional observational study
dyspepsia
gastrointestinal
hba1c
pancreatic exocrine insufficiency
peptic ulcer disease
type 2 diabetes mellitus
small intestinal bacterial overgrowth
title Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
title_full Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
title_fullStr Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
title_full_unstemmed Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
title_short Assessment of the Clinical Profile of Dyspepsia with Predominantly Abdominal Bloating Symptoms in Type 2 Diabetes Mellitus Patients: A Cross-sectional Observational Study
title_sort assessment of the clinical profile of dyspepsia with predominantly abdominal bloating symptoms in type 2 diabetes mellitus patients a cross sectional observational study
topic cross-sectional observational study
dyspepsia
gastrointestinal
hba1c
pancreatic exocrine insufficiency
peptic ulcer disease
type 2 diabetes mellitus
small intestinal bacterial overgrowth
url https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8071
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