UD, functional heartburn (FH), and IBS were defined by the Rome III criteria (18). Dyspepsia was subclassified into epigastric pain syndromes (EPS), postprandial distress syndromes (PDS), and EPS-PDS overlap (18). Significant impairment of QoL was considered when symptoms affected it a lot or a great deal. The PU was defined as an area of the denuded epithelium of 5 mm or more. Acute gastric or duodenal erosions were defined as a mucosal break of ≤ 5 mm in diameter. All gastric ulcers were biopsied for histology. Duodenal bulb deformity was considered when flattening, scars, stenosis, or narrowing of the bulb were seen.

FD was defined as dyspepsia without any structural disease that was likely to explain symptoms. Duodenitis or duodenal erosions, PU, and erosive esophagitis (EE) defined OD. Gastritis or gastric erosion was not included in OD because these do not cause dyspeptic symptoms, do not incur the risk of PU (19), and were included as FD in a previous study (20). On the other hand, endoscopic duodenitis or duodenal erosion correlates with dyspeptic symptoms and response to treatment (20,21).

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