Evidence map›Paper›PMID 37389172›Full record

ArticleGastro hep advances2023

Unrecognized Functional Dyspepsia Among Those With Refractory Chronic Constipation: Analysis of a Tertiary Cohort.

Taylor Boyd, Mary Paz, Imama Ahmad, Fatima Rao, Ahmad Samad, Isabelle Garcia-Fischer, Casey Silvernale, Helen Burton Murray, Kyle Staller

Abstract read
In one paragraph

Article in Gastro hep advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Avoidant-Restrictive Food Intake Disorder in Patients With Gastrointestinal Disorders: A Systematic Review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Taylor BoydHarvard Medical School, Boston, Massachusetts.
Mary PazCenter for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Imama AhmadCenter for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Fatima RaoCenter for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Ahmad SamadCenter for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Isabelle Garcia-FischerCenter for Neurointestinal Health, Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
Casey SilvernaleSidney Kimmel Medical College, Philadelphia, Pennsylvania.
Helen Burton MurrayHarvard Medical School, Boston, Massachusetts.
Kyle StallerHarvard Medical School, Boston, Massachusetts.

Funding

Clinical Coordinating Center for the Health Initiative in Early Phase Pain Investigation Clinical NetworkU24NS113850 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI EDWARDS, ROBERT R, FAVA, MAURIZIO · 2019 to 2023
$9.4M
A Biobehavioral Approach to Understand Problematic Avoidant/Restrictive Eating in Adults with Functional DyspepsiaK23DK131334 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI BURTON MURRAY, HELEN · 2021 to 2025
$1.1M
The Role of Fiber in the Etiopathogenesis of Fecal IncontinenceK23DK120945 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI STALLER, KYLE · 2020 to 2024
$1.0M
NIDDK NIH HHS K23 DK120945NIDDK NIH HHS K23 DK131334NINDS NIH HHS U24 NS113850
6 · The paper itself

Abstract

BACKGROUND AND

aimsPatients with functional constipation (FC) are frequently dissatisfied with current treatment options which may be related to persistent, unaddressed symptoms. We hypothesized that refractory FC may actually represent functional dyspepsia (FD) overlap. Among adults presenting with refractory FC, we sought to (1) identify the prevalence of concurrent FD and (2) identify the symptoms and presentations most frequently associated with concurrent FD and FC.

methodsWe assembled a retrospective cohort of 308 patients sequentially presenting to a tertiary neurogastroenterology clinic for evaluation of refractory FC, defined as having failed first-line therapy. Using Rome IV criteria, trained raters identified the presence and characteristics of concurrent FD in addition to demographics, presenting complaints, and psychological comorbidities.

resultsAmong 308 patients presenting with refractory FC (average of 3.0 ± 2.3 constipation treatments tried unsuccessfully), 119 (38.6%) had concurrent FD. Aside from meeting FD criteria, the presence of concurrent FD was associated with patient complaints of esophageal symptoms (Odds ratio = 3.1; 95% confidence interval, 1.80-5.42) and bloating and distension (Odds ratio = 2.67; 95% confidence interval, 1.50-4.89). Patients with concurrent FD were more likely to have a history of an eating disorder (21.0% vs 12.7%) and were also more likely to present with current avoidant/restrictive food intake disorder-related symptoms (31.9% vs 21.7%).

conclusionAlmost 40% of adult patients referred for refractory FC met criteria for concurrent FD in a tertiary-level cohort. The presence of both FC and FD was associated with greater esophageal symptoms and bloating/distention. Determining presence of concurrent FD may represent an additional therapeutic opportunity in refractory patients who may attribute symptoms to FC alone.

Indexed as

Disorders of Gut-Brain InteractionFunctional ConstipationFunctional DyspepsiaOverlap

Identifiers

PMID37389172
PMCPMC10310299

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.