Sensory and pressure responses to gastric distension were evaluated in 24 consecutive patients suffering from chronic idiopathic dyspepsia and 20 healthy subjects. A latex balloon was placed in the proximal stomach and inflated by increments of 100 ml of air up to a maximal volume of 800 ml. Symptom response and intragastric pressure-volume curve were recorded during the gradual balloon distension. Thirteen of the 24 patients experienced pain at a distension volume less than or equal to 400 ml of air, but only one of the 20 controls (P less than 0.001). Intragastric pressure-volume curves were similar in patients and controls, and in patients with and without abnormal pain threshold, suggesting that a compliance defect was not the cause of the sensory anomaly. Gastric emptying of solids and liquids was measured in 20 of the 24 patients using a dual isotopic technique; psychological status was also evaluated in 18 patients using the Mini-Mult test. The frequency of the sensory anomaly was not different in patients with (7/14) or without (4/6) gastric stasis, but was lower in patients with (5/13) than in those without psychological disturbances (5/5, P less than 0.01). Thus, a primary visceral sensory anomaly, either alone or in conjunction with motility disturbances, can play an important role in chronic idiopathic dyspepsia and must be taken in account for further therapeutic research.

The factors that influence colonic transit time in healthy humans are not yet clearly defined. The aim of this study was therefore to determine (a) if there are differences in colonic transit time between men and women and (b) if age, female hormonal status or smoking habits are associated with alterations in these parameters. Colonic transit time was measured in 164 asymptomatic subjects (80 males, 84 females) by a radio-opaque marker technique with one single plain abdominal X-ray. Colonic transit time was significantly shorter in men than in women (30 +/- 2 vs. 42 +/- 3 h, P < 0.05). Colonic transit time in non-smoking males was significantly shorter compared with smoking males (26 +/- 2 vs. 40 +/- 5 h, P < 0.05). In females only height and menstrual cycle influenced colonic transit times. We conclude that gender and smoking habits should be considered when studying colonic transit time in health and disease.

The solitary rectal ulcer syndrome (SRUS) is a disease which is commonly diagnosed in adults but only rarely described in children. Rectal prolapse and intussusception are frequently associated with this entity. A relationship between SRUS and chronic constipation due to spastic pelvic floor syndrome (SPFS) is often observed. Thus biofeedback defaecation training is an efficient treatment of both conditions. We describe two paediatric patients suffering from SRUS associated with SPFS who showed complete recovery after biofeedback defaecation training.