Investigation of Gastric Emptying Disorders in Patients with Functional Dyspepsia Reveals Impaired Inhibitory Gastric Emptying Regulation in the Early Postcibal Period

Abstract

Background/Aims: The aim of the study was to investigate gastric emptying profiles in patients with postprandial distress syndrome (PDS) as a means to understand relationships between gastric emptying and dyspepsia. Methods: Gastric emptying times were measured using a ¹³C breath test. In addition to comparisons of ¹³C half excretion times (t 1/2 ex) between patients with PDS and healthy subjects, gastric emptying (%dose/h) curves were analyzed using a multipeak curve-fitting technique, and fitted curves were differentiated to measure the slope of curves for each time point. Results: (1) During the early postcibal period, the slope of %dose/h curves in 27% of patients with PDS was larger than the average slope derived from healthy subjects. The t 1/2 ex was also higher in these patients relative to healthy subjects. (2) During the midpostcibal period, the slope of %dose/h curves in 36% of PDS patients was larger than the average slope derived from healthy subjects. There was a trend toward lower t 1/2 ex values for these patients relative to control subjects. (3) When t 1/2 ex was calculated overall, however, there was no significant difference between healthy subjects and patients with PDS. Conclusion: Our findings document abnormal gastric outflow in patients with PDS. In some patients, there appears to be a significant correspondence between PDS-related dyspepsia and accelerated gastric emptying in the early postcibal period, whereas other patients showed a similar correspondence between dyspepsia and impaired inhibitory gastric emptying regulation in the midpostcibal period.

Review: Evaluation and management of dyspepsia

“…early postprandial period or impaired inhibitory gastric emptying in the mid postprandial period supporting the observation that functional dyspepsia is a heterogeneous disorder [Zai and Kusano, 2009].…”

Leu72Met408 Polymorphism of the Ghrelin Gene Is Associated With Early Phase of Gastric Emptying in the Patients With Functional Dyspepsia in Japan

“…Analyses of dysregulation of early phase of gastric emptying are necessary to elucidate the pathphysiology of FD patients. 29 Accelerated gastric emptying in the early postprandial period may be associated with impaired accommodation. 39,40 In addition, in a scintigraphic study, early redistribution of the meal to the distal stomach or accelerated gastric emptying in the postprandial period, suggestive of impaired accommodation, was associated with symptoms of early satiety.…”

Gastroptosis is Associated with Less Dyspepsia, Rather than a Cause of Dyspepsia, in Japanese Persons

“…Moreover, the large capacity of the stomach in persons with gastroptosis might mean that a larger volume is needed to trigger TLESR than in persons with a normal stomach or cascade stomach. Recently, early gastric emptying has been suggested to have an important role in the development of dyspepsia (13)(14)(15), rather than delayed gastric emptying (3,4,16). It was reported that patients with severe nausea and vomiting have very rapid emptying of swallowed barium during fluoroscopy (17).…”