Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients

Abstract

Abstract Abstract Abstract AIM: Delayed gastric emptying and an enlarged fasting gastric antrum are common findings in functional dyspepsia but their relationship with gastrointestinal (GI), and the frequently associated extra-GI symptoms remains unclear. This study evaluated the relationship between GI and extra-GI symptoms, fasting antral volume and delayed gastric emptying in functional dyspepsia. METHODS:In 108 functional dyspeptic patients antral volume and gastric emptying were assessed with ultrasonography (US). Symptoms were assessed with standardized questionnaire. The association of symptoms and fasting antral volume with delayed gastric emptying was estimated with logistic regression analysis. RESULTS:Delayed gastric emptying was detected in 39.8% of the patients. Postprandial drowsiness (AOR 11.25; 95%CI 2.75-45.93), nausea (AOR 3.51; 95%CI 1.19-10.32), fasting antral volume (AOR 1.93; 95%CI 1.22-3.05), were significantly associated with delayed gastric emptying. Symptoms, mainly the extra-GI ones as postprandial drowsiness and nausea, combined with fasting antral volume predicted the modality of gastric emptying with a sensitivity and specificity of 78%. CONCLUSION:In functional dyspeptic patients, (1) an analysis of fasting antral volume and of symptoms can offer valuable indication on the modality of gastric emptying, and (2) it seems appropriate to inquire on postprandial drowsiness that showed the best correlation with delayed gastric emptying.

Acotiamide Hydrochloride (Z-338), a New Selective Acetylcholinesterase Inhibitor, Enhances Gastric Motility without Prolonging QT Interval in Dogs: Comparison with Cisapride, Itopride, and Mosapride

“…Delayed gastric emptying has been described in approximately 20 to 40% of patients with FD (Talley et al, 2001;Sarnelli et al, 2003;Lorena et al, 2004;Pallotta et al, 2005), and postprandial gastric antral hypomotility has been shown in patients with FD (Kusunoki et al, 2000). Gastroprokinetic agents are probably useful for the treatment of FD, and symptoms do subside with an improvement in gastric motility dysfunction (Talley, 1995;Allescher et al, 2001;Mizuta et al, 2006).…”

“…Although standard diagnostic tests in patients with FD fail to identify an underlying organic abnormality (Talley et al, 1999), delayed gastric emptying has been described in approximately 20 to 40% of patients (Talley et al, 2001;Sarnelli et al, 2003;Lorena et al, 2004;Pallotta et al, 2005). Patients with FD have also shown postprandial gastric antral hypomotility (Kusunoki et al, 2000).…”

Electroacupuncture improves impaired gastric motility and slow waves induced by rectal distension in dogs

“…These patients frequently complain of upper abdominal symptoms such as bloating, upper abdominal discomfort or pain, and vomiting. The symptoms overlap with lower abdominal symptoms and are resistant to dietary and pharmacological treatments because of the constipation issues; they are related to the presence of impaired gastrointestinal myoelectrical activity and reduced upper gastrointestinal motor activity (1,4,13,31,33,37). This phenomenon has led to the hypothesis that rectal distension (RD) with fecal stasis in the colorectal region directly causes reflexive inhibition of proximal gastrointestinal motility (5,7,9,22,32,50).…”

Gastroparesis associated with gastroesophageal reflux disease and corresponding reflux symptoms may be corrected by radiofrequency ablation of the cardia and esophagogastric junction

“…On nuclear scans for a subset of patients with GERD, we documented conditions of delayed gastric emptying that may be contributors to the nonresponding symptoms [14]. Pallotta et al [20] documented the relationship of persistent gastrointestinal symptoms and delayed gastric emptying in dyspeptic patients. Cahan et al [21] showed that PPI therapy may be a causative factor in depressing digestive output.…”