Duodenal Villi Eosinophils: Association with Functional Dyspepsia Symptoms, but Not with Helicobacter pylori Infection.

Purpose: Duodenal eosinophils have been associated with functional dyspepsia, but its association with Helicobacter pylori (H. pylori) remains unclear. Our aim was to investigate the connection between eosinophils in duodenal villi and dyspeptic symptoms, as well as its association with H. pylori infection.

Methods: We evaluated 100 functional dyspeptic patients, 50 H. pylori positive and 50 H. pylori negative, all meeting Rome III criteria. Participants underwent upper gastrointestinal endoscopy with gastric and duodenal biopsies. Duodenal villi eosinophil were counted in 5 random high-power fields (HPF). We evaluated the association between duodenal villi eosinophils and dyspeptic symptoms using the validated PADYQ questionnaire. Duodenal villi eosinophils were also compared between H. pylori-positive and -negative groups and analyzed according to demographic and endoscopic variables.

Results: Patients were predominantly female (88%) with a mean age of 41.8 years. Median eosinophil/HPF in duodenal villi were 4.6 [2.8-7.2] in H. pylori negative and 4.7 [3.4-8.4] in H. pylori positive subjects (p = 0.40). Duodenal villi eosinophil increased with symptom severity: 3.4 [2.2-6.0] for mild, 4.7 [3.2-6.4] for moderate and 5.8 [3.6-8.2] for severe symptoms (p = 0.03). Multivariate analysis showed that duodenal villi eosinophils were independently associated with smoking (p = 0.02) and symptom severity (p = 0.04).

Conclusion: Duodenal villi eosinophils did not correlate with H. pylori infection but was associated with dyspepsia symptoms severity.