Proton pump inhibitors and suppression of duodenal eosinophilia in functional dyspepsia

We read with interest the study by Molina-Infante et al1 regarding proton pump inhibitor (PPI) responsive oesophageal eosinophilia. The authors emphasise that the benefit of PPI therapy may be secondary to anti-inflammatory effects (blocking of STAT 6) rather than antisecretory properties, which raises the question whether PPI therapy may be beneficial in other eosinophilic disease of the gastrointestinal tract. We report here novel observations of the effect of PPI therapy on duodenal eosinophilia in patients with functional dyspepsia (FD) which lends further support to this hypothesis.

FD is characterised by bothersome postprandial symptoms that cannot be easily be explained at upper gastrointestinal endoscopy.2 It is further subdivided into the postprandial distress syndrome (PDS), comprising patients who report early satiety or the inability to finish a regular sized meal, and the epigastric pain syndrome, comprising those with epigastric pain or burning which may or may not be postprandial. FD...

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