Rapid initial gastric emptying and hypersensitivity to gastric filling in functional dyspepsia: Effects of duodenal lipids

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

doi:10.1080/00365520600590513

Cited by 47 publications

(31 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

Objective Gastroptosis is recognized by its characteristic appearance on barium studies. The present prospective study assessed the relationship between gastroptosis and dyspeptic symptoms. Methods Japanese subjects underwent health screening, and gastroptosis was diagnosed by barium studies. Consecutive subjects (500 women and 167 men) with gastroptosis were identified and the same number of age-matched subjects without gastroptosis were selected as controls. Dyspepsia was classified as reflux-like (heartburn and belching), dysmotility-like (bloating and fullness), or ulcer-like dyspepsia (epigastralgia) based on the Rome II criteria. Results Body mass index was significantly lower in women with gastroptosis than in controls [19.7±1.83 (SD) vs. 23.4±3.70, p<0.0001], and also in men (19.7±2.00 vs. 23.9±2.89, p<0.0001). The incidence of dyspepsia was significantly lower in women with gastroptosis than in controls (56/500 vs.87/500, p<0.01) and also in men (10/167 vs. 25/167, p<0.05), especially in women with ulcer-like dyspepsia (15/500 vs. 32/500, p<0.05) and in men with reflux-like dyspepsia (2/167 vs. 12/167, p<0.05). By logistic regression analysis, gastroptosis was associated with a lower risk of dyspepsia (odds ratio: 0.62, 95% CI: 0.405-0.941, p=0.025) and ulcer-like dyspepsia (odds ratio: 0.36, 95% CI: 0.177-0.726, p=0.004) in women. Conclusion Dyspeptic symptoms were significantly less common in subjects with gastroptosis. Accordingly, gastroptosis may protect against dyspeptic symptoms, rather than causing functional dyspepsia.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Several reports suggest that gastric emptying is impaired in some FD patients, and a meta-analysis indicates that gastric emptying is significantly delayed in almost 40 % of patients with FD [19]. Most studies failed to find a convincing relationship between delayed gastric emptying and symptom pattern, and some studies reported rapid gastric emptying after meals [20] in some FD patients. Visceral hypersensitivity is also regarded as a pathophysiologic factor, and hypersensitivity has been reported to gastric distension [21] and to acid and fat infusion to the duodenum [22].…”

Section: Pathophysiologymentioning

confidence: 99%

Evidence-based clinical practice guidelines for functional dyspepsia

et al. 2015

View full text Add to dashboard Cite

General interest in functional gastrointestinal disorders is increasing among Japanese doctors as well as patients. This increase can be attributed to a number of factors, including recent increased interest in quality of life and advances in our understanding of the pathophysiology of gastrointestinal disease. Japan recently became the world's first country to list ''functional dyspepsia'' as a disease name for national insurance billing purposes. However, recognition and understanding of functional dyspepsia (FD) remain poor, and no standard treatment strategy has yet been established. Accordingly, the Japanese Society of Gastroenterology (JSGE) developed an evidence-based clinical practice guideline for FD, consisting of five sections: concept, definition, and epidemiology; pathophysiology; diagnosis; treatment; and prognosis and complications. This article summarizes the Japanese guideline, with particular focus on the treatment section. Once a patient is diagnosed with FD, the doctor should carefully explain the pathophysiology and benign nature of this condition, establish a good doctor-patient relationship, and then provide advice for daily living (diet and lifestyle modifications, explanations, and reassurance). The proposed pharmacological treatment is divided into two steps: initial treatment including an acid inhibitory drug (H2RA or PPI) or prokinetics, (strong recommendation); second-line treatment including anxiolytics, antidepressants, and Japanese traditional medicine (weak recommendation). H. pylori eradication, strongly recommended with a high evidence level, is positioned separately from other treatment flows. Conditions that do not respond to these treatment regimens are regarded as refractory FD. Patients will be further examined for other organic disorders or will be referred to specialists using other approaches such as psychosomatic treatment.

show abstract

“…In addition, Kusano et al have reported that rapid gastric emptying might be a more important factor than delayed gastric emptying in patients with FD [21]. Another study has reported that gastric emptying rate (ml/min) at 5min of the patients with FD was significantly higher compared to healthy volunteers [5]. However, early phase of gastric emptying could not be evaluated by T max value or T 1/2 values.…”

Section: Introductionmentioning

confidence: 85%

“…Most of FD patients complain various symptoms related to the intake of meals; however, the athophysiology of FD remains poorly defined [2,3]. A number of potentially important abnormalities have been reported in FD patients, including impaired fundic accommodation [4], gastric hypersensitivity to distention [5], abonormal duodenojejunal motility [6], duodenal motor and sensory dysfunction [7], duodenal hypersensitivity [8], hereditary factors [9,10], Helicobacter pylori infection [11] and other infections. Impairment of gastric motility such as gastric emptying is strongly associated with the pathophysiology of FD, one of the most common gastrointestinal disorders [12].…”

Section: Introductionmentioning

confidence: 99%

Distinct Associations Between Depression Status and Initial Phase of Gastric Emptying in Functional Dyspepsia and Healthy Volunteers

Futagami¹

2014

Int J Gastroenterol Disord Ther

View full text Add to dashboard Cite

Background/Aims: The association between initial phase of gastric emptying and clinical symptoms and depression status in functional dyspepsia has not been studied in detail. Methods: The subjects were 20 patients with Rome III-based functional dyspepsia and healthy volunteers. We evaluated upper abdominal symptoms using GDSS score and used Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Gastric motility was evaluated with the 13 C-acetate breath test. Results: AUC 15 value as initial gastric emptying within 15 mins in FD patients was significantly higher compared to that in healthy volunteers. T max value as a marker of delayed gastric emptying in FD patients was also significantly higher compared to that in healthy volunteers. There were not significant relationships between clinical symptoms and AUC 5 and AUC 15 values in FD patients and healthy volunteers. In contrast, there were significant correlations (p=0.047, p=0.049) between SRQ-D score and AUC 5 and AUC 15 values in healthy volunteers, albeit there were not significant correlations in FD patients. Conclusions: Impairment of AUC 15 or AUC 15 /AUC inf as well as delayed gastric emptying would play important roles in functional dyspepsia. Further studies are necessary to clarify whether various clinical symptoms and depression status are related to initial gastric emptying at postprandial 15 mins phase.

show abstract

Rapid initial gastric emptying and hypersensitivity to gastric filling in functional dyspepsia: Effects of duodenal lipids

Cited by 47 publications

References 36 publications

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

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

Evidence-based clinical practice guidelines for functional dyspepsia

Distinct Associations Between Depression Status and Initial Phase of Gastric Emptying in Functional Dyspepsia and Healthy Volunteers

Contact Info

Product

Resources

About