Evidence map›Paper›PMID 41571956›Full record

ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2026

Prevalence and clinical implications of duodenal eosinophilia in patients with refractory functional dyspepsia: A cross-sectional analysis.

Omesh Goyal, Manisha Khubber, Manjeet Kumar Goyal, Harpreet Kaur, Varun Mehta, Ramit Mahajan, Yogesh Gupta, Arshdeep Singh, Ajit Sood

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Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Omesh Goyal *Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India. dromeshgoyal@gmail.com.ORCID http://orcid.org/0000-0002-6347-0988
Manisha Khubber *Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Manjeet Kumar GoyalDepartment of Internal Medicine, Cleveland Clinic Akron General, Akron, USA.
Harpreet KaurDepartment of Pathology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Varun MehtaDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Ramit MahajanDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Yogesh GuptaDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Arshdeep SinghDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.
Ajit SoodDepartment of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141 001, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesFunctional dyspepsia (FD) is a common disorder with multi-factorial pathophysiology. It has two sub-types, post-prandial distress syndrome (PDS) and epigastric pain syndrome (EPS), which frequently overlap. Emerging evidence suggests that low-grade inflammation, particularly duodenal eosinophilia (DE), may play a pathogenic role in FD. However, Indian data on this subject remains scarce. This study aimed at evaluating the prevalence and clinical correlates of DE in patients with refractory FD.

methodsIn this prospective, cross-sectional study, Rome- IV defined FD patients with refractory symptoms and normal esophagogastroduodenoscopy (EGD) were enrolled. Age and sex-matched non-dyspeptic controls with normal EGD were also recruited. Standardized duodenal biopsies from cases and controls were independently assessed by two blinded histopathologists for eosinophil counts and degranulation. Symptom profiles and health-related quality of life (HRQoL) were evaluated using validated questionnaires.

resultsOf 274 patients with refractory dyspepsia screened, 189 patients with normal EGD (mean age 41.4 ± 15.2 years; 54.5% males) were enrolled, along with 96 controls. The mean duodenal eosinophil count in controls was 8.2 ± 1.5 per high-power field (HPF). Applying the mean + 3 standard deviation criteria, DE was defined as ≥ 13 eosinophils/HPF. DE was identified in 65.3% (123/189) of refractory FD patients (65.7% in EPS, 52.5% in PDS and 69.1% in the overlap group, p > 0.05). Duodenal eosinophil counts correlated positively with PDS symptom severity (r = 0.376; p < 0.0001), overlap symptom severity (r = 0.3; p = 0.031) and worse HRQoL (r = 0.21; p = 0.010). Furthermore, patients with eosinophilic degranulation (24.3%) had significantly higher PDS scores and worse HRQoL scores, compared to those without degranulation.

conclusionsUp to two-thirds of the refractory FD patients exhibited duodenal eosinophilia, which was associated with increased symptom severity in PDS and overlap sub-types and poorer HRQoL. These findings support the incorporation of duodenal mucosal assessment in the diagnostic algorithm for refractory FD.

Indexed as

Duodenal inflammationEpigastric pain syndromePost-prandial distress syndromeProton pump inhibitorsQuality of life

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PMID41571956

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