Functional Dyspepsia Patients Willing to Take Significant Risks to Cure Symptoms

Currently there are no FDA-approved pharmacological treatments for functional dyspepsia (FD), although an array of medications are used to attempt to relieve symptoms. New research in the journal Clinical and Translational Gastroenterology sought to identify and describe FD patients' medication risk-taking behaviors (primary objective) and self-reported medical side effects, prevalence of anxiety and depression, and relationship of self-reported FD severity to anxiety, depression, and willingness to take medication risks (secondary objectives).

Questionnaires from 114 patients diagnosed with FD were reviewed for the study; the mean age of the patients was 49.2 years and 84% of FD patients were women. Thirty-one percent rated their symptoms as mild, 40% as moderate, and 27% as severe. Upper abdominal discomfort was rated as the most bothersome symptom (25%), followed by upper abdominal pain (22%) and bloating (15%). When asked about the use of a hypothetical medication that could permanently cure their FD symptoms, 49% of respondents reported that they would accept a mean 12.7% risk of sudden death (range 1–90%) for a 99% chance of cure. Although the differences were not statistically significant, patients with severe FD symptoms were willing to take more risks with a hypothetical medication to cure FD vs. those with self-related moderate and mild symptoms. 

Hospital Anxiety and Depression (HAD) scores were higher in the FD respondents compared to the general population, but when total HAD scores and HAD subscores for anxiety and depression were analyzed with respect to risk-taking behavior, no differences were found. Patients with both postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) were more willing to take risks with a hypothetical medication than those with PDS alone, and patients with EPS were more willing to take medication risks than those with only PDS (although this was not statistically significant).

When treating patients with FD, these findings suggest that it may be beneficial for clinicians to consider risk adversity in treatment plans, which may vary based on symptom severity.

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