Pressure-induced gastric accommodation studied with a new distension paradigm. Abnormally low accommodation rate in patients with functional dyspepsia

Lunding, Johan A.; Tefera, Solomon; Bayati, A.; Gilja, Odd Helge; Mattsson, Hillevi; Hausken, Trygve; Berstad, Arnold

doi:10.1080/00365520500353723

Cited by 13 publications

(26 citation statements)

References 33 publications

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“…Any animal model can of course be questioned as far as the human relevance is concerned. However, by using a similar gastric distension paradigm (ramptonic) in humans, it was demonstrated that FD patients had a lower accommodation rate and lower maximal gastric volume as compared with healthy subjects [25], which is analogous to that in WKY and SD rats, respectively. Our major observation in this study is that in WKY rats, atropine treatment resulted in a substantial increase in gastric volume, whereas no significant effects of atropine were seen in SD rats.…”

Section: Discussionmentioning

confidence: 94%

Wistar Kyoto rats have impaired gastric accommodation compared to Sprague Dawley rats due to increased gastric vagal cholinergic tone

Nielsen

Bayati

Mattsson

2006

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 94%

Wistar Kyoto rats have impaired gastric accommodation compared to Sprague Dawley rats due to increased gastric vagal cholinergic tone

Nielsen

Bayati

Mattsson

2006

Scandinavian Journal of Gastroenterology

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“…In some studies, the volume of the proximal stomach reached a peak value at about 2-5 min after ingestion of the test meal (Gilja et al, 1995;Gilja et al, 1996;Undeland et al, 1998;Lunding et al, 2006). In contrast, in the standard procedure using a barostat, the volume of the intragastric bag connected to the barostat increases every 2-3 min (Mearin et al, 1991;Kim et al, 2001).…”

Section: Figmentioning

confidence: 99%

Simple and non-invasive assessment of the accommodation reflex of the proximal stomach

Kusunoki

Haruma

Hara

et al. 2010

J Smooth Muscle Res

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Background: Impaired gastric accommodation of the proximal stomach is one of the major pathophysiological mechanisms in functional dyspepsia (FD). However, no useful method exists for the clinical evaluation of this phenomenon. Aim: The aim of the present study was to establish a simple and non-invasive method for evaluating the accommodation reflex of the proximal stomach. Methods: Nine healthy subjects received up to 1,700 mL water (stepwise administration in 100-mL increments) using a nasogastric tube while they were in a supine position. To assess the meal-induced gastric accommodation reflex, we measured the cross-sectional area of the proximal stomach via ultrasonography (US) at 3-min intervals after administration of water. We also measured the pressure of the water column using the same tube. Then, we administrated up to 400 mL of water in 100-mL increments and measured the area of the proximal stomach in 44 FD patients with early satiation (the measurements were performed at intervals of 3-min), and we compared the results with those for 44 healthy subjects. Results: The incremental changes in the area of the proximal stomach corresponded well with the amount of water administered. The area of the proximal stomach increased, but the antral area and the intragastric pressure remained relatively stable. After administration of more than 100 ml water, the area of the proximal stomach in healthy subjects was significantly greater than that in FD patients.

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“…In our speculation, rabeprazole may enhance distension-induced gastric accommodation, then it attenuates the volume-dependent increments in luminal pressure, and consequently delays GE of 1,000 ml water. This speculation should be confirmed using a more sophisticated methodology [4].…”

Section: To the Editormentioning

confidence: 95%

“…The nutrientinduced accommodation is studied using the gastric barostat by monitoring the incremental change in barostat volume after a caloric liquid meal, while keeping intragastric pressure constant. However, by this conventional barostat technique, the distension (pressure)-induced accommodation cannot be evaluated [4]. A recent study has shown that rapid gastric emptying (GE) of 1,000 ml of water can be a surrogate marker of impaired distensioninduced accommodation [5]: after aggressive gastric filling with 1,000 ml water, the resultant elevation in intragastric pressure determines GE, and therefore the higher luminal pressure due to the defective accommodation, accelerates GE [5].…”

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confidence: 99%

Does Rabeprazole Enhance Distension-Induced Gastric Accommodation?

2008

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To the EditorPostprandial relaxation of the proximal stomach, namely gastric accommodation, is a key mechanism for understanding symptom generation in functional dyspepsia [1]. Impaired gastric accommodation raises the postprandial intragastric pressure, thereby generating dyspeptic symptoms such as early satiety [1]. On the other hand, proton pump inhibitors (PPIs) are effective for relieving dyspeptic symptoms [1]. A human study has shown that rabeprazole, one of the newer drugs in the PPI class, increases production of nitric oxide, which mediates the relaxant response of the proximal stomach to a meal [2]. These observations suggest the possibility that PPIs enhance gastric accommodation. However, the possibility has not yet been addressed.Gastric accommodation is induced by duodenal exposure to nutrients or by gastric distension [3]. The nutrientinduced accommodation is studied using the gastric barostat by monitoring the incremental change in barostat volume after a caloric liquid meal, while keeping intragastric pressure constant. However, by this conventional barostat technique, the distension (pressure)-induced accommodation cannot be evaluated [4]. A recent study has shown that rapid gastric emptying (GE) of 1,000 ml of water can be a surrogate marker of impaired distensioninduced accommodation [5]: after aggressive gastric filling with 1,000 ml water, the resultant elevation in intragastric pressure determines GE, and therefore the higher luminal pressure due to the defective accommodation, accelerates GE [5]. In reverse, it is logical to consider that GE of 1,000 ml water is delayed when the distension-induced accommodation is enhanced. The aim of this preliminary study was to test our hypothesis that rabeprazole delays GE of 1,000 ml water. If the hypothesis is true, the enhancing effect of rabeprazole on distension-induced gastric accommodation will indirectly be supported.Nine, healthy, Helicobacter pylori-seronegative, male volunteers (30-39 years, 55-85 kg) were enrolled. All gave written informed consents and the study was approved by the Ethics Committee of Teikyo University. The [ 13 C]-acetate breath test was performed on two randomized occasions [6,7], which were at least 1 week apart. On one occasion, 20 mg of rabeprazole was orally administered for the preceding 2 days, and 1 h before the breath test on the third day. The last dose of rabeprazole was taken with 200 ml water. On the other occasion, the subjects received no pretreatment, but they drank 200 ml water 1 h before the test. On breath testing, 1,000 ml of mineral water containing 200 mg [ 13 C]-acetate was given at a rate of 200 ml/ min. Breath samples were collected at baseline and at 5-min intervals for 2 h. The half [ 13 CO 2 ] excretion time (t 1/2b ) and the time of the maximal [ 13 CO 2 ] (t lag ) were calculated [7]. Time course data of the [ 13 CO 2 ] excretion were analyzed using two-way repeated measures of analysis of variance, followed by a post hoc paired Student's t-test. Summary data (t 1/2b and t lag ) were analyze...

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Pressure-induced gastric accommodation studied with a new distension paradigm. Abnormally low accommodation rate in patients with functional dyspepsia

Abstract: This new barostat paradigm allowed detailed analysis of short-term pressure-induced accommodation in man. Impaired gastric distension-induced accommodation is a novel abnormality in FD.

Cited by 13 publications

References 33 publications

Wistar Kyoto rats have impaired gastric accommodation compared to Sprague Dawley rats due to increased gastric vagal cholinergic tone

Wistar Kyoto rats have impaired gastric accommodation compared to Sprague Dawley rats due to increased gastric vagal cholinergic tone

Simple and non-invasive assessment of the accommodation reflex of the proximal stomach

Does Rabeprazole Enhance Distension-Induced Gastric Accommodation?

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