Gastroenterology

Gastroenterology

Volume 121, Issue 3, September 2001, Pages 526-535
Gastroenterology

Alimentary Tract
Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia

https://doi.org/10.1053/gast.2001.27180Get rights and content

Abstract

Background & Aims: Hypersensitivity to gastric distention has been reported in functional dyspepsia, but its characteristics and relevance to symptoms remain unclear. The aim of this study was to define hypersensitivity to gastric distention and its association to specific symptoms in functional dyspepsia. Methods: We used a gastric barostat to study sensitivity to gastric distention in 80 healthy subjects and in 160 functional dyspepsia patients. Demographic characteristics, gastric emptying, Helicobacter pylori status, gastric accommodation, and a dyspepsia symptom score were obtained from all patients and the relationship with visceral sensitivity was assessed using univariate and multivariate analysis. Results: The increase of intra-balloon pressure over intra-abdominal pressure needed to induce discomfort or pain is the most appropriate expression of sensitivity to gastric distention because it yields a meaningful lower range of normal and it is independent from age and body mass index. Hypersensitivity to gastric distention was found in 34% of the patients, who did not differ from the other patients in demographic and other pathophysiological characteristics. Hypersensitivity to distention was associated with a higher prevalence of postprandial pain, belching, and weight loss. Conclusions: Hypersensitivity to gastric distention is present in a subset of functional dyspepsia patients. It is associated with symptoms of postprandial epigastric pain, belching, and weight loss.

GASTROENTEROLOGY 2001;121:526-535

Section snippets

Study subjects

Eighty healthy controls (52 men; age, 19–31 years; mean age, 24.7 ± 2.3 years) and 160 patients with functional dyspepsia (51 men; age, 16–79 years; mean age, 40.1 ± 13.9 years) participated in this study. None of the healthy subjects had symptoms or a history of gastrointestinal disease or drug allergies, nor were they taking any medication.

The patients presented to the outpatient clinic because of meal-related epigastric symptoms, and all underwent careful history taking and clinical

Characteristics of patients with functional dyspepsia

Patients were significantly older than healthy subjects, and a higher proportion of the patients were female (P < 0.01). Dyspeptic symptoms were present for 21 ± 7 months. Table 1 summarizes the grading of dyspeptic symptoms in the patient group.

. Frequency of severity grading for each of 6 dyspepsia symptoms in 160 patients with functional dyspepsia

Empty Cell0 (Absent)1 (Mild)2 (Relevant)3 (Severe)
Postprandial fullness16 (10)10 (6)43 (27)91 (57)
Bloating31 (19)9 (6)48 (30)72 (45)
Epigastric pain49 (31)11 (7)

Discussion

Visceral hypersensitivity has been put forward as a unifying pathophysiological concept that may underlie several functional gastrointestinal disorders.8, 9 Several studies have clearly established that, as a group, patients with functional dyspepsia display enhanced sensitivity to gastric distention.3, 5, 6, 10, 11 However, in these studies, different approaches to calculate sensitivity to gastric distention and to determine the range of normality have been used.3, 5, 6, 10, 11 By consequence,

References (22)

  • J Danesh et al.

    Systematic review of the epidemiological evidence on Helicobacter pylori infection and nonulcer or uninvestigated dyspepsia

    Arch Intern Med

    (2000)
  • Cited by (0)

    Address requests for reprints to: Jan Tack, M.D., Ph.D., Division of Gastroenterology, Department of Internal Medicine, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. e-mail: [email protected]; fax: (32) 16-34-44-19.

    View full text