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Reduced mastication is a risk factor for Rome IV postprandial distress syndrome in patients investigated with upper endoscopy - 24/11/22

Doi : 10.1016/j.clinre.2022.102032 
Roberta Neuwald Pauletti a, Sidia M Callegari-Jacques b, Laura Fornari c, Iran de Moraes d, Fernando Fornari a, c, e,
a Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade de Passo Fundo (UPF), Passo Fundo-RS, Brazil 
b Departamento de Estatística, Universidade Federal do Rio Grande do Sul, Porto Alegre-RS, Brazil 
c Faculdade de Medicina, UPF, Passo Fundo, Brazil 
d Clínica EndoDiagnóstico, Passo Fundo, Brazil 
e Clínica Endopasso, Passo Fundo, Brazil 

Corresponding author at: BR285, São José, CEP 99052-900, Passo Fundo-RS.BR285, São José, CEP 99052-900, Passo Fundo-RS

Highlights

Reduced mastication could force the stomach and contribute to dyspeptic symptoms.
We assessed the masticatory function of patients evaluated with upper endoscopy.
A quarter of these patients presented reduced mastication.
Reduced mastication was associated with postprandial distress syndrome.
Dyspeptic patients may benefit from referring to dental evaluation.

Le texte complet de cet article est disponible en PDF.

Abstract

Background and aims

Reduced mastication could force the stomach to do extra work on crushing food and contribute to dyspeptic symptoms. This study aimed to assess the relationship between mastication and dyspepsia.

Methods

This cross-sectional study involved 209 consecutive patients referred for elective upper endoscopy. Before endoscopy, an expert dentist performed an oral examination and scored chewing function in three levels (normal, regular, and reduced), and applied questionnaires for assessment of dyspepsia (Rome IV), xerostomia, and mastication (normal, regular, and reduced). A reduced masticatory function was defined when an oral examination or mastication questionnaire rated the chewing as poor. Associations between mastication, confounders, and dyspepsia were estimated by prevalence ratio [PR (95% Confidence Interval)] using Poisson regression.

Results

Thirty-four patients showed relevant organic conditions in the upper gastrointestinal tract (moderate to severe reflux oesophagitis, peptic ulcer, neoplasia, and surgical modification) and were excluded. Among 175 patients with non-organic diseases (aging 51.3 ± 15.7 years; 61.7% women), 50 (28.6%) had reduced mastication, and 125 (71.4%) had normal/regular mastication. After adjusting for age and xerostomia, reduced mastication was associated with postprandial distress syndrome [PR = 1.93 (95%CI 1.27 – 2.91)] but not with epigastric pain syndrome [PR = 1.09 (95%CI 0.75 – 1.60)].

Conclusions

In patients referred for upper digestive endoscopy, reduced mastication was associated with postprandial distress syndrome but not with epigastric pain syndrome. An interdisciplinary approach with dentists and physicians might benefit dyspeptic patients with postprandial distress syndrome.

Le texte complet de cet article est disponible en PDF.

Keywords : Dyspepsia, Mastication, Postprandial distress syndrome, Xerostomia


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Vol 46 - N° 10

Article 102032- décembre 2022 Retour au numéro
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