Comments on ‘Impaired duodenal mucosal integrity and low-grade inflammation in functional dyspepsia’ by Vanheel et al

We note with great interest the finding by Vanheel et al of increased intestinal permeability in a series of patients with functional dyspepsia (FD). This represents an important contribution to the study of this disease.1 This has previously been observed in patients with IBS, which has led researchers to consider whether the two disorders, customarily considered to be functional, might have an underlying organic basis.2 Nevertheless, we find the information provided about the patient selection criteria to be insufficient, and we would like a complementary explanation of this matter. The 15 patients with FD included in this study were all negative for Helicobacter pylori . The fulfilment of this requirement may partially account for the small sample, but we would be in a better position to judge this if we knew the mean prevalence of H pylori infection in the adult population of Belgium, how many patients in the series had previously received eradication therapy, the time elapsed before their inclusion in the study and the detection method used. The authors …