▁( 9 5 % ▁CI , ▁ 0 . 8 9 – 1 . 8 9 ; ▁P ▁= ▁ 0 . 1 8 ). ▁Still , ▁no ▁effect ▁was ▁seen ▁after ▁adjust ing ▁for ▁heter ogene ity ▁and ▁for ▁c ure ▁of ▁H . ▁p yl ori . ▁In ▁contrast , ▁a ▁C och rane ▁review ▁found ▁a ▁small ▁but ▁statist ically ▁significant ▁effect ▁in ▁cur ing ▁sympt oms ▁( H . ▁p yl ori ▁c ure ▁vs ▁place bo , ▁ 3 6 % ▁vs ▁ 3 0 %, ▁respectively ). ▁ ▁System ic ▁dise ases ▁There ▁are ▁a ▁number ▁of ▁system ic ▁dise ases ▁that ▁may ▁involve ▁d ys pe ps ia , ▁including ▁coron ary ▁disease , ▁con gest ive ▁heart ▁failure , ▁di ab etes ▁m ell it us , ▁hyper par ath y roid ism , ▁thy roid ▁disease , ▁and ▁chron ic ▁kid ney ▁disease . ▁ ▁Du oden al ▁micro - infl amm ation ▁ ▁Du oden al ▁micro - infl amm ation ▁caused ▁by ▁an ▁alter ed ▁du oden al ▁gut ▁micro bi ota , ▁re actions ▁to ▁food s ▁( main ly ▁gl uten ▁prote ins ) ▁or ▁in fe ctions ▁may ▁indu ce ▁d ys pe ps ia ▁sympt oms ▁in ▁a ▁subset ▁of ▁people . ▁ ▁Path oph ys i ology ▁ ▁Psych os om atic ▁and ▁cogn itive ▁factors ▁are ▁important ▁in ▁the ▁evaluation ▁of ▁patients ▁with ▁chron ic ▁d ys pe ps ia . ▁The ▁psych iat ric ▁hypothesis