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Introduction

Almost 80% of individuals with functional dyspepsia report meal-related symptoms and are classified as having postprandial distress syndrome (PDS). However, studies evaluating dietary modifications in PDS are sparse.

Aims & Methods

The aim of this study was to perform a single-centre randomized trial evaluating traditional dietary advice (TDA) in PDS.
Following a normal upper gastrointestinal endoscopy, patients with PDS were randomly assigned to a leaflet providing reassurance and diagnostic explanation (RADE) +/- TDA; the latter recommending smaller, regular meals and reducing the intake of caffeine/alcohol/fizzy drinks, fatty/processed/spicy foods, and fibre. Questionnaires were completed during the 4-week trial, including self-reported adequate relief of dyspeptic symptoms, and the validated Leuven Postprandial Distress Scale (LPDS), Gastrointestinal Symptom Rating Scale, and Nepean Dyspepsia Index for quality of life. The primary endpoint(s) to define clinical response were i) ≥50% adequate relief of dyspeptic symptoms, and ii) >0.5-point reduction in the PDS subscale of the LPDS (calculated as the mean scores for early satiety, postprandial fullness, and upper abdominal bloating).

Results

Of 53 patients with PDS, 27 were assigned RADE-alone and 26 to additional TDA. Baseline characteristics were similar between the groups, with a mean age of 39 years, 70% female, 83% white, and co-existent IBS in 66%. The primary endpoints of i) adequate relief of dyspeptic symptoms was met by 33% (n=9) assigned RADE-alone vs. 39% (n=10) with TDA; p-value=0.70, while ii) a reduction of >0.5 points in the PDS subscale was met by 37% (n=10) assigned RADE-alone vs. 27% (n=7) with TDA; p-value=0.43. Response rates did not alter according to IBS status. There were no significant between-group changes in the gastrointestinal symptom rating scale and dyspepsia quality of life.

Conclusion

The addition of TDA did not lead to greater symptom reduction in PDS compared with reassurance and diagnostic explanation alone. Alternate dietary strategies should be explored in PDS.

RANDOMIZED TRIAL OF TRADITIONAL DIETARY ADVICE IN POSTPRANDIAL FUNCTIONAL DYSPEPSIA

Rachel Buckle 1, Lydia Brown 1, Imran Aziz 1

1 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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The trend towars single use components

Event

UEG Week Copenhagen 2023

Topics

Nurses

Session

New trends and developments in hygiene and infection control

Published

2023

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The trend towards singlue-use components

Sanja Hruškar 1, Marko Videc 2

1 KBC Rebro, Zagreb, Croatia

2 GH Dubrava Zagreb, Zagreb, Croatia

Event

UEG Week Copenhagen 2023

Topics

Nurses

Session

New trends and developments in hygiene and infection control

Published

2023

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Reprocessing: Let the work flow

Paul Caesar 1

1 PENTAX Medical EMEA, Langezwaag, Netherlands

Event

UEG Week Copenhagen 2023

Topics

Nurses

Session

New trends and developments in hygiene and infection control

Published

2023

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The endoscopy academy lead nurse–strategy and outcomes

Phedra Dodds 1

1 JAG, London, United Kingdom

Event

UEG Week Copenhagen 2023

Topics

Education & Training Endoscopy Nurses

Session

Free papers I: Management and patient safety

Published

2023

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Introduction

Hepatocellular carcinoma (HCC) is the leading cause of death in patients with cirrhosis. Indeed, several risk stratification scores have been developed to anticipate early detection in order to better codify their management, including the Toronto Hepatocellular Carcinoma Risk Index (THRI). It is a simple and validated tool that has been developed to predict the risk of HCC in patients with cirrhosis and is mainly based on the following parameters: etiology, age, sex and platelet count.
The objective of this study was to evaluate the reliability of the THRI score in predicting the occurrence of hepatocellular carcinoma.

Aims & Methods

We conducted a monocentric retrospective study collecting all cirrhotic patients over an 8-year period [2008-2015]. Clinico-biological data, disease severity, and long-term outcomes were collected.
THRI was calculated for all patients, and were classified according to HCC risk into three levels : low HCC risk (<120), intermediate HCC risk (between 120 and 240), and those with high HCC risk (>240).
A statistical study using the SPSS tool was carried out. The performance of this score was evaluated with the area under the receiver operating characteristics curve (AUROC).

Results

We included 120 cirrhotic patients with an M/F sex ratio equal to 0.5. The mean age was 57 years [14-85]. The most frequent aetiology of cirrhosis were viral C (49%) and viral B (31%). The mean overall survival was approximately 6 years after diagnosis.
Twenty-five patients developed HCC during follow-up (20.8%). Patients who developed HCC had a higher THRI score than those who did not develop HCC : 264.8 ± 48.6 versus 232.3 ± 64.8, respectively with p-value = 0.008
Patients with a low risk of HCC were 5 (4.2%), none of whom had developed HCC. Fifty-eight patients (48.3%) were at intermediate risk, 12% of them (N=7) had developed HCC. The remaining 57 patients (47.5%) were at a high risk and 31.6% of them (N=18) developed HCC during their follow-up.
The AUROC for the THRI to predict HCC was 0.649 ([95% CI 0.533–0.765]. The cutoff THRI value in predicting the occurrence of HCC was 235.5 with a sensitivity of 72% and a specificity of 50%.

Conclusion

According to our study, the THRI score appears to be an effective tool for predicting the occurrence of HCC in cirrhotic patients. Its good sensitivity allows to identify the high-risk HCC population for early screening.