A new clinical study has identified a potential link between abnormal urinalysis and somatisation symptoms in female patients with epigastric pain syndrome (EPS), a subtype of functional dyspepsia (FD). FD is a common digestive disorder characterised by persistent upper abdominal symptoms without identifiable organic causes.
EPS, defined by pain or burning in the upper abdomen, is increasingly recognised as a disorder of gut-brain interaction with strong ties to psychological factors such as anxiety, depression and somatisation.
The study found that female EPS patients with poor response to standard proton pump inhibitor (PPI) therapy often exhibited abnormal urinalysis results, including elevated urinary erythrocytes and leukocytes. These abnormalities were significantly correlated with the severity of somatisation symptoms and reduced quality of life.
After four weeks of treatment combining conventional PPIs with flupentixol/melitracen (FM), a psychoactive compound with antidepressant and anti-anxiety properties, patients experienced marked improvements in gastrointestinal symptoms, mood, and urinalysis findings. In contrast, those on PPI-only therapy continued to show strong correlations between urinalysis abnormalities and somatisation.
The researchers propose that these findings may reflect a gut–brain–bladder axis, with emotional disorders influencing both digestive and urinary symptoms through shared autonomic pathways and systemic inflammatory responses. This theory is supported by prior research showing overlap between urinary and gut microbiota, as well as shared involvement in neuroimmune regulation.
Importantly, the study also demonstrated that urinary erythrocyte levels were independently associated with dyspepsia severity, even after controlling for psychological scores. The data suggest that urinalysis could serve as a potential biomarker for treatment response in female EPS patients with somatisation.
While promising, the study acknowledges limitations including its small sample size, single-gender focus, and lack of a double-blind design. Researchers call for larger, multicentre trials to confirm the role of FM in treating EPS with coexisting somatisation and urinary abnormalities. If validated, these findings could pave the way for more personalised, multisystem treatment approaches for complex FD cases.
Reference
Pu F et al. Flupentixol/melitracen for epigastric pain syndrome in female patients with abnormal urinalysis and therapeutic insights into the brain-bladder axis. Sci Rep. 2025;15(1):25331.
