Adverse Childhood Experiences Are Associated With an Increased Risk of Dyspepsia in Patients Undergoing Upper Endoscopy

Background and Aims

Stress is a risk factor for dyspepsia; however, neither the type nor timing of stress exposures across the lifespan in this syndrome are well understood. We aimed to understand the association between both adverse childhood experiences (ACEs) and experience of current life stress with dyspepsia by collecting and analyzing survey data from a racially diverse cohort of adult research patients presenting for upper endoscopy (esophagogastroduodenoscopy).

Methods

The Gastric Immune Response and Cancer Interception study is a cohort study that enrolled adults scheduled for esophagogastroduodenoscopy at an academic center and administered a detailed survey, including questions on ACEs, current adult stress, and dyspepsia symptoms. Endoscopy and pathology results were abstracted from the medical record. Multivariable logistic regression was performed to determine the association between stress exposures and dyspepsia outcomes.

Results

Among 187 participants who completed dyspepsia questions, exposure to 2 or more ACEs compared to none was associated with over a two-and-a-half-fold increase in the odds of self-reported dyspepsia (age-adjusted odds ratio = 2.56; 95% confidence interval: 1.24–5.25), with the strongest association with ACE measures of childhood abuse. ACEs were also associated with epigastric pain syndrome (P < .001) and mixed syndrome (P = .0001), but not with postprandial distress syndrome (P = .095). No association was found between current adult stress and dyspepsia.

Conclusion

In patients undergoing endoscopy, exposure to multiple ACEs were associated with dyspepsia. These findings suggest that assessing ACEs in patients with dyspepsia could help provide additional insights into factors associated with dyspepsia symptoms beyond Helicobacter pylori infection and acid-related injury.