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Background and Aim: Some patients with functional gastrointestinal disorders exhibit pancreatic dysfunctions and pancreatic enzyme abnormalities. Thus, we aimed to clarify whether significant differences in clinical characteristics, prevalence of pancreatic enzyme abnormalities, duodenal inflammation, and protease‐activated receptor 2 (PAR2) expression levels related to hypersensitivity exist between functional dyspepsia (FD) alone and FD‐irritable bowel syndrome (IBS) overlap group. Methods: Ninety‐three patients based on the Rome IV criteria, FD alone (n = 44) and FD overlapped with IBS (n = 49) group were enrolled. The patients scored their own clinical symptoms after consuming high‐fat meals. Serum trypsin, PLA2, lipase, p‐amylase, and elastase‐1 levels were measured. PAR2, eotaxin‐3, and TRPV4 mRNA levels in duodenum were determined using real‐time polymerase chain reaction methods. PRG2‐ and PAR2 in the duodenum were evaluated using immunostaining. Results: FD score and global GSRS in patients with FD‐IBS overlap were significantly higher than FD alone. Although the prevalence of pancreatic enzyme abnormalities in patients with FD alone was significantly (P < 0.01) higher than that in FD‐IBS overlap, the ratio of aggravation of clinical symptoms following high‐fat intake in patients with FD‐IBS overlap was significantly higher (P = 0.007) than that in patients with FD alone. PAR2‐ and PRG2‐double positive cells were localized in the degranulated eosinophils in the duodenum of patients with FD‐IBS overlap. The number of PAR2‐ and PRG2‐double positive cells in FD‐IBS overlap was significantly (P < 0.01) higher than FD alone. Conclusions: Pancreatic enzyme abnormalities and PAR2 expression on degranulated eosinophils infiltrations in the duodenum may be associated with the pathophysiology of patients with FD‐IBS overlap in Asian populations. [ABSTRACT FROM AUTHOR]

Background and Aim: To clarify whether there were any significant differences in clinical symptoms and eating patterns between functional dyspepsia (FD) patients and FD with pancreatic enzyme abnormalities (FD‐P) patients as refractory FD, we compared these factors in multicenter studies in Singapore and Japan. Methods: One hundred ninety‐eight consecutive patients presenting with FD (n = 88), FD‐P patients (n = 81) based on Rome III classification and controlled group (n = 39) recruited from six institutions in Singapore and Japan. Clinical characteristics, clinical symptoms for dietary fat intake, and eating behaviors were estimated using questionnaires. Anxiety and health‐related quality of life were determined by STAI‐state/‐trait and SF‐8, respectively. Results: There were no significant differences in age, sex, BMI, smoking, alcohol intake, past medical history, and history of allergy in FD and FD‐P patients between Singapore and Japan. There were no significant differences in FD subtypes, gastrointestinal symptom rating scale score, severity of FD symptoms, and eating pattern in Singapore and Japan. Moreover, there were significant differences in certain eating behaviors between FD and FD‐P patients in Singapore and Japan. Interestingly, epigastric pain and early satiety following fat meals in FD‐P patients were significantly (P = 0.003 and P = 0.008, respectively) higher compared with those in FD patients in Japan. Physical component score in FD‐P patients was significantly (P = 0.019) disturbed compared with those in FD patients in Japan. Conclusions: Epigastric pain and early satiety following fat meals in FD‐P patients may be useful tools to differentiate FD‐P patients from FD patients in Japan. [ABSTRACT FROM AUTHOR]