SPINK1 and pancreatitis: In our study, we excluded early chronic pancreatitis from patients with R-FD with a score of < 2 on endoscopic ultrasonography (EUS) [7]. Since vonoprazan- and acotiamide-R-FD highly exhibited pancreatic enzyme abnormalities, we investigated the association between single-nucleotide polymorphisms (SNPs) associated with pancreatitis, such as G-protein-coupled receptor class C group 6 member A​​​​​​​ (GPRC6A) and serine protease inhibitor, Kazal type 1 (SPINK1) [8,9], and R-FD using EUS.