1
|
Ventura F, Gawdi R, German Z, Patel A, Westcott C, Clayton S. Association of preoperative workup and comorbidities with risk of gastroesophageal surgery failure. Ann Gastroenterol 2024; 37:321-326. [PMID: 38779646 PMCID: PMC11107399 DOI: 10.20524/aog.2024.0874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/24/2024] [Indexed: 05/25/2024] Open
Abstract
Background While surgical failure rates for fundoplication and hiatal hernia repair are low, there has been no clear evaluation of the preoperative risk factors associated with surgical failure. This study aimed to identify risk factors predisposing patients to surgical failure. Methods Patients who underwent antireflux surgery during a 3-year period were evaluated for evidence of surgical complications and placed accordingly into the failure or control group. Demographic data, comorbidities, clinical presentation, preoperative evaluation, and surgical data were collected and compared between the groups. Results In total, 86 patients with failure and 42 controls were identified among our cohort. No significant differences were found between groups based on sex (P=0.640). However, patients with failure were younger than controls (57.0 vs. 64.7 years, P=0.0001). Body mass index, tobacco use and alcohol use did not differ significantly between the groups (P=0.189, P=0.0999, P=0.060). Notably, psychiatric illness was more common in the failure group (P=0.0086). Neither hypertension (P=0.134) nor diabetes (P=0.335) had significant differences between groups. For procedures, no significant differences were found for the frequencies of preoperative imaging (P=0.395) or manometry (P=0.374), but pH/BRAVO studies (P=0.0193) and endoscopy (P<0.001) were both performed more frequently in the failure group. Conclusions Patients with psychiatric comorbidities are at higher risk of surgical failure. Alcohol use trended toward significance, which warrants further investigation. We also noted an increase in rates of preoperative pH and endoscopy studies, contrary to the prior literature; this is likely due to more complex cases requiring additional workup.
Collapse
Affiliation(s)
- Frank Ventura
- Atrium Health Wake Forest Baptist Medical Center (Frank Ventura)
| | - Rohin Gawdi
- Wake Forest University School of Medicine (Rohin Gawdi, Zach German, Ana Patel, Carl Westcott, Steven Clayton), Winston-Salem, NC, USA
| | - Zach German
- Wake Forest University School of Medicine (Rohin Gawdi, Zach German, Ana Patel, Carl Westcott, Steven Clayton), Winston-Salem, NC, USA
| | - Ana Patel
- Wake Forest University School of Medicine (Rohin Gawdi, Zach German, Ana Patel, Carl Westcott, Steven Clayton), Winston-Salem, NC, USA
| | - Carl Westcott
- Wake Forest University School of Medicine (Rohin Gawdi, Zach German, Ana Patel, Carl Westcott, Steven Clayton), Winston-Salem, NC, USA
| | - Steven Clayton
- Wake Forest University School of Medicine (Rohin Gawdi, Zach German, Ana Patel, Carl Westcott, Steven Clayton), Winston-Salem, NC, USA
| |
Collapse
|
2
|
Stieler M, Carter G, Spittal MJ, Campbell C, Pockney P. Somatic symptom severity, depression and anxiety associations with pancreatitis and undifferentiated abdominal pain in surgical inpatients. ANZ J Surg 2024; 94:634-639. [PMID: 38156726 DOI: 10.1111/ans.18801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/28/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Somatic Symptom Disorder is a psychiatric diagnosis that describes the experience of physical symptoms and associated distress, that is disproportionate to recognized organic pathology. Somatic symptom severity (SSS) may be associated with some surgical diagnoses; particularly the complex pain associated with pancreatitis, or the diagnostic ambiguity of undifferentiated abdominal pain (UAP). We aimed to estimate the prevalence of SSS in different diagnostic groups in surgical inpatients with abdominal pain; and to estimate the magnitude and direction of any association of SSS, anxiety and depression. METHODS Cross sectional analysis (n = 465) of adult admissions with non-traumatic abdominal pain, at a tertiary hospital in Australia. We estimated SSS with the Patient Health Questionnaire-15 (PHQ-15), depression with the Patient Health Questionnaire (PHQ-9) and anxiety with the General Anxiety Disorder (GAD-7), at standard cut-points ≥ 10; comparing acute pancreatitis (n = 20), chronic pancreatitis (n = 18) and UAP (n = 64) versus other causes of abdominal pain. RESULTS Somatic symptoms were common, 52% having moderate and 19.6% severe SSS. There was an association between moderate SSS and pancreatitis (OR 2.11, 95% CI 1.05-4.25) and depressive symptoms and chronic pancreatitis (OR = 3.47, 95% CI 1.31-9.24). There was no significant association between the four mental health categories and UAP. CONCLUSIONS SSS and psychological comorbidity were common in a surgical inpatients admitted for abdominal pain and equally represented across most diagnostic sub-groups. However, the pancreatitis sub-group had greater proportions with clinically significant SSS and depression, suggesting that they have a higher requirement for psychological assessment and intervention.
Collapse
Affiliation(s)
- Melissa Stieler
- College of Health, Medicine and Wellbeing, School of Medicine and Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Gregory Carter
- College of Health, Medicine and Wellbeing, School of Medicine and Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia
- Department Consultation-Liaison Psychiatry, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cassidy Campbell
- Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Peter Pockney
- College of Health, Medicine and Wellbeing, School of Biological Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
3
|
S2k-Leitlinie Gastroösophageale Refluxkrankheit und eosinophile Ösophagitis der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – März 2023 – AWMF-Registernummer: 021–013. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:862-933. [PMID: 37494073 DOI: 10.1055/a-2060-1069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
|
4
|
Qi M, Zhou Y, Zhou YX, Fang SQ. Progress in research of pathogenesis of refractory gastroesophageal reflux disease. Shijie Huaren Xiaohua Zazhi 2022; 30:769-774. [DOI: 10.11569/wcjd.v30.i17.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Refractory gastroesophageal reflux disease (rGERD) is a common clinical disease with many pathogenic factors, complex mechanisms, and increasing incidence. At present, scholars believe that the pathogenesis of rGERD is closely related to intra- and extra-esophageal factors. Elucidating the mechanism of rGERD can contribute to the diagnosis and treatment of the disease. This paper summarizes the current progress in the research of the pathogenesis of rGERD, and puts forward our own thoughts and prospects for the disease, in order to provide ideas for the in-depth study of the pathogenesis of rGERD.
Collapse
Affiliation(s)
- Mei Qi
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200080, China
| | - Yue Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200080, China
| | - Yu-Xuan Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200080, China
| | - Sheng-Quan Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200080, China
| |
Collapse
|
5
|
Fuchs KH, Musial F, Eypasch E, Meining A. Gastrointestinal Quality of Life in Gastroesophageal Reflux Disease: A Systematic Review. Digestion 2022; 103:253-260. [PMID: 35605592 DOI: 10.1159/000524766] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The Gastrointestinal Quality of Life Index (GIQLI) is a well-established instrument for the assessment of quality of life (QOL) in gastrointestinal (GI) diseases. The purpose of this literature review was to investigate QOL by means of GIQLI in patients with gastroesophageal reflux disease (GERD) prior to any interventional therapy. There are several reports on GIQLI data; however, comparisons from different countries and/or different GERD cohorts assessing the same disease have to date not been conducted. METHODS The GIQLI uses 36 items around 5 dimensions (GI symptoms [19 items], emotional dimension [5 items], physical dimension [7 items], social dimension [4 items], and therapeutic influences [1 item]). A literature search was conducted on the application of GIQLI in GERD patients prior to interventional therapy using reports in PubMed. Data on the mean GIQLI as well as index data for the 5 dimensions as originally validated were extracted from the published patient cohorts. A comparison with the normal healthy control group from the original publication of the GIQLI validation conducted by Eypasch was performed. Data are presented descriptively as GIQLI points as well as a reduction from 100% maximum possible index points (max 144 index points = highest QOL). RESULTS In total, 77 abstracts from studies using the GIQLI on patients with GERD were identified. After screening for content, 21 publications were considered for further analysis. Ten studies in GERD patients comprised complete calculations of all dimensions and were included in the analysis. Data from 1,682 study patients were evaluated with sample sizes ranging from 33 to 568 patients (median age of 789 females and 858 males: 51.8 years). The median overall GIQLI for the patient group was 91.7 (range 86-102.4), corresponding to 63.68% of the maximum GIQLI. The dimensions with the largest deviation from the respective maximum score were the physical dimension (55% of maximum) followed by the emotional dimension (60% of maximum). In summary, the GIQLI level in GERD cohorts was reduced to 55-75% of the maximum possible index. CONCLUSIONS Severe GERD causes substantial reductions in the patient's QOL. The level of GIQLI can carry between different studied GERD cohorts from different departments and countries. GIQLI can be used as an established tool to assess the patient's condition in various dimensions.
Collapse
Affiliation(s)
- Karl-Hermann Fuchs
- Laboratory for Interventional and Experimental Endoscopy InExEn, Gastroenterology, University of Würzburg, Würzburg, Germany
| | - Frauke Musial
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, NAFKAM, UiT, The Arctic University of Norway, Tromsø, Norway
| | | | - Alexander Meining
- Laboratory for Interventional and Experimental Endoscopy InExEn, Gastroenterology, University of Würzburg, Würzburg, Germany
| |
Collapse
|
6
|
Fuchs KH, Breithaupt W, Varga G, Babic B, Schulz T, Meining A. Primary laparoscopic fundoplication in selected patients with gastroesophageal reflux disease. Dis Esophagus 2022; 35:6277415. [PMID: 34002235 DOI: 10.1093/dote/doab032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/30/2021] [Accepted: 04/20/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite proton pump inhibitors being a powerful therapeutic tool, laparoscopic fundoplication (LF) has proven successful in the treatment of gastroesophageal reflux disease (GERD), through mechanical augmentation of a weak antireflux barrier and the advantages of minimally invasive access. A critical patient selection for LF, based on thorough preoperative assessment, is important for the management of GERD-patients. The purpose of this study is to provide an overview on the management of GERD-patients treated by primary LF in a specialized center and to illustrate the possible outcome after several years. METHODS Patients were selected after going through diagnostic workup consisting of patient's history and physical examination, upper gastrointestinal endoscopy, assessment of gastrointestinal Quality of Life Index, screening for somatoform disorders, functional assessment by esophageal manometry, (impedance)-24-hour-pH-monitoring, and selective radiographic studies. The indication for LF was based on EAES-guidelines. Either a floppy and short Nissen fundoplication was performed or a posterior Toupet-hemifundoplication was chosen. A long-term follow-up assessment was attempted after surgery. RESULTS In total, n = 1131 patients were evaluated (603 males; 528 females; mean age; 48.3 years; and mean body mass index: 27). The mean duration between onset of symptoms and surgery was 8 years. Nissen: n = 873, Toupet: n = 258; conversion rateerativ: 0.5%; morbidity 4%, mortality: 1 (1131). Mean follow-up (n = 898; 79%): 5.6 years; pre/post-op results: esophagitis: 66%/12.1%; Gastrointestinal Quality of Life Index: median: 92/119; daily proton pump inhibitors-intake after surgery: 8%; and operative revisions 4.3%. CONCLUSIONS In conclusion, our data show that careful patient selection for laparoscopic fundoplication and well-established technical concepts of mechanical sphincter augmentation can provide satisfying results in the majority of patients with severe GERD.
Collapse
Affiliation(s)
- K H Fuchs
- Laboratory for Interventional and Experimental Endoscopy, University of Würzburg, Würzburg, Germany
| | - W Breithaupt
- Department of General and Visceral Surgery, St. Elisabethen Krankenhaus, Frankfurt, Germany
| | - G Varga
- AGAPLESION Markus Krankenhaus, Department of General and Visceral Surgery, Frankfurt, Germany
| | - B Babic
- University of Cologne, Department of General-, Visceral-and Cancer Surgery, Cologne, Germany
| | - T Schulz
- Department of General and Visceral Surgery, St. Elisabethen Krankenhaus, Frankfurt, Germany
| | - A Meining
- Laboratory for Interventional and Experimental Endoscopy, University of Würzburg, Würzburg, Germany.,University of Würzburg, Zentrum Innere Medizin, Head of Gastroenterology, Würzburg, Germany
| |
Collapse
|
7
|
Fuchs KH, Lee AM, Breithaupt W, Varga G, Babic B, Horgan S. Pathophysiology of gastroesophageal reflux disease-which factors are important? Transl Gastroenterol Hepatol 2021; 6:53. [PMID: 34805575 DOI: 10.21037/tgh.2020.02.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/10/2020] [Indexed: 12/16/2022] Open
Abstract
Background Pathophysiology of gastroesophageal reflux disease (GERD) shows a multifactorial background. Different anatomical and functional alterations can be determined such as weakness of the lower esophageal sphincter (LES), changes in anatomy by a hiatal hernia (HH), an impaired esophageal motility (IEM), and/or an associated gastric motility problem with either duodeno-gastro-esophageal reflux (DGER) or delayed gastric emptying (DGE). The purpose of this study is to assess a large GERD-patient population to quantitatively determine different pathophysiologic factors contributing to the disease. Methods For this analysis only patients with documented GERD (pathologic esophageal acid exposure) were selected from a prospectively maintained databank. Investigations: history and physical, body mass index, endoscopy, esophageal manometry, 24 h-pH-monitoring, 24 h-bilirbine-monitoring, radiographic-gastric-emptying or scintigraphy, gastrointestinal quality of life index (GIQLI). Results In total, 728 patients (420 males; 308 females) were selected for this analysis. Mean age: 49.9 years; mean BMI: 27.2 kg/m2 (range, 20-45 kg/m2); mean GIQLI of 91 (range: 43-138; normal level: 121); no esophagitis: 30.6%; minor esophagitis (Savary-Miller type 1 or Los Angeles Grade A): 22.4%; esophagitis [2-4]/B-D: 36.2%; Barrett's esophagus 10%. Presence of pathophysiologic factors: HH 95.4%; LES-incompetence 88%, DGER 55%, obesity 25.6%, IEM 8.8%, DGE 6.8%. Conclusions In our evaluation of GERD patients, the most important pathophysiologic components are anatomical alterations (HH), LES-incompetence and DGER.
Collapse
Affiliation(s)
- Karl-Hermann Fuchs
- Department of Surgery, Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA
| | - Arielle M Lee
- Department of Surgery, Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA
| | - Wolfram Breithaupt
- AGAPLESION Markus Krankenhaus, Klinik für Allgemeine und Viszeralchirurgie, Frankfurt am Main, Germany
| | - Gabor Varga
- AGAPLESION Markus Krankenhaus, Klinik für Allgemeine und Viszeralchirurgie, Frankfurt am Main, Germany
| | - Benjamin Babic
- Klinik und Poliklinik für Allgemeine-, Viszeral- und Tumorchirurgie, Universitätskliniken Köln, Cologne, Germany
| | - Santiago Horgan
- Department of Surgery, Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
8
|
Kivelä AJ, Kauppi J, Räsänen J, But A, Sintonen H, Vironen J, Kruuna O, Scheinin T. Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication. World J Surg 2021; 45:1495-1502. [PMID: 33502565 PMCID: PMC8026436 DOI: 10.1007/s00268-021-05954-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND We aim to shed light on long-term subjective outcomes after re-operations for failed fundoplication. METHODS 1809 patients were operated on for hiatal hernia and/or gastroesophageal reflux disease (GERD) at the Helsinki University Hospital between 2000 and 2017. 111 (6%) of these had undergone a re-operation for a failed antireflux operation. Overall, HRQoL was assessed in 89 patients at the latest follow-up using the generic 15D© instrument. The results were compared to a sample of the general population, weighted to reflect the age and gender distribution of patients. Disease-specific HRQoL was assessed using the GERD-HRQoL questionnaire. We studied variation in the overall HRQoL with respect to disease-specific HRQoL and known patients' parameters using univariate and multivariable linear regression models. RESULTS The median postoperative follow-up period was 9.3 years. All patients were operated on laparoscopically (6% conversion rate), and 87% were satisfied with the re-operation. Postoperative complications were minimal (5%). Twelve patients (11%) underwent a second re-operation. The median GERD-HRQoL score was nine. In multivariable analysis, four variables were independently associated with the 15D score, suggesting a decrease in the 15D score with increasing GERD-HRQoL score, increasing Charlson Comorbidity Index (CCI) and the presence of chronic pain syndrome (CPS) and depression. CONCLUSION Re-do LF is a safe procedure in experienced hands and may offer acceptable long-term alleviation in patients with recurring symptoms after antireflux surgery. Decreased HRQoL in the long run is related to recurring GERD and co-morbidities.
Collapse
Affiliation(s)
- Antti J Kivelä
- Department of GI Surgery, Abdominal Centre, Helsinki University Hospital and Helsinki University, Jorvi Hospital, Turuntie 150, P.O. Box 800, FI 00029, Espoo, Helsinki, HUS, Finland.
| | - Juha Kauppi
- Department of General Thoracic and Esophageal Surgery, Lung and Heart Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Jari Räsänen
- Department of General Thoracic and Esophageal Surgery, Lung and Heart Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Anna But
- University of Helsinki, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaana Vironen
- Department of GI Surgery, Abdominal Centre, Helsinki University Hospital and Helsinki University, Jorvi Hospital, Turuntie 150, P.O. Box 800, FI 00029, Espoo, Helsinki, HUS, Finland
| | - Olli Kruuna
- Department of GI Surgery, Abdominal Centre, Helsinki University Hospital and Helsinki University, Jorvi Hospital, Turuntie 150, P.O. Box 800, FI 00029, Espoo, Helsinki, HUS, Finland
| | - Tom Scheinin
- Department of GI Surgery, Abdominal Centre, Helsinki University Hospital and Helsinki University, Jorvi Hospital, Turuntie 150, P.O. Box 800, FI 00029, Espoo, Helsinki, HUS, Finland
| |
Collapse
|
9
|
Yang F, Xie XH, Li X, Liao HN, Zou B. Analysis of Psychological and Gut Microbiome Characteristics in Patients With Non-erosive Reflux Disease. Front Psychiatry 2021; 12:741049. [PMID: 35095588 PMCID: PMC8793911 DOI: 10.3389/fpsyt.2021.741049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To assess the correlation between the incidence of non-erosive reflux disease (NERD) and psychological factors, especially somatoform disorders. To investigate the characteristics of gut microbiome in NERD patients. Methods: We enrolled 24 NERD patients and 24 healthy controls. All patients were evaluated via GerdQ, SOMS-7, SAS, HAMA, and HAMD. Fecal samples were collected and 16S rRNA sequencing was performed to evaluate the gut microbiome composition. Results: The main symptoms of the NERD patients were regurgitation (87.5%), belching (66.7%), pharyngeal discomfort (50%), and heartburn (37.5%). The average score of GerdQ was 13.42 ± 3.41. In 15 patients (62.5%), the total score of the last two items was <3 points, while the average score of 24 patients was 3.63 ± 2.32. NERD patients with somatoform disorders accounted for 50%. There were 17 patients without anxiety, 6 patients with mild anxiety (25%), 1 patient with moderate anxiety (4.2%), and no patient with severe anxiety. There were 22 patients (91.7%) without depression, 2 patients (8.3%) with mild depression, and no patient with moderate or severe depression. The alpha diversity of NERD group was higher than HC, which showed significant difference (P < 0.05). The beta-diversity was significantly different between HC and NERD patients (P = 0.026), male and female patients (P = 0.009). The beta-diversity was also significantly different between male and female patients (P = 0.009). There were several bacteria with significant differences between HC and NERD group, and NERD patients with or without somatoform disorders, such as Firmicutes, TM7 were enriched in the NERD group compared with the healthy control group, while Bacteroidetes were enriched in the healthy controls. Conclusions: NERD symptoms overlap with somatoform disorders. NERD symptoms have an impact on the daily life quality of patients. Some of them are accompanied by anxiety and depression of different degrees, and the two are significantly correlated. The diversity of gut microbiome in patients with NERD is significantly higher than healthy controls, which has its characteristics. The predominant bacteria in gut microbiome of patients with NERD are similar to the healthy population, with Firmicutes and Bacteroidetes as the main ones. The composition of gut microbiome in NERD patients with or without somatoform disorder is significantly different, which may be related to the interaction of microbiome-brain-gut axis.
Collapse
Affiliation(s)
- Fan Yang
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xin-Hui Xie
- Department of Psychiatry, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.,Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, China.,Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, China
| | - Xi Li
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hui-Na Liao
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Bing Zou
- Department of Gastroenterology, Peking University Shenzhen Hospital, Shenzhen, China
| |
Collapse
|