OBJECTIVE: Functional dyspepsia is a heterogeneous disorder and different pathophysiological mechanisms underlie its symptom patterns. This study investigated the relationship between dyspepsia symptoms and overall and proximal gastric emptying in patients with functional dyspepsia. METHODS: A total of 93 patients with functional dyspepsia and 32 healthy subjects were enrolled in this cross-sectional study. Prevalence and severity of eight dyspepsia symptoms were recorded. Gastric emptying was measured using single photon emission computed tomography scanning. RESULTS: Overall and proximal gastric emptying were delayed in 47.3% (44/93) and 46.2% (43/93) of the patients, respectively. Logistic regression analyses showed that presence of nausea was associated with delayed proximal gastric emptying (odds ratio 4.951; 95% confidence interval 1.321, 18.558). There were no significant differences between normal and delayed overall gastric emptying according to presence of symptoms. CONCLUSIONS: Presence of nausea might indicate delayed gastric emptying of the proximal stomach. Promotion of proximal gastric emptying may constitute an effective therapy for patients with functional dyspepsia who report nausea as the dominant symptom.

ObjectiveThis study was performed to investigate impaired vagal activity to meal in patients with functional dyspepsia (FD) with delayed gastric emptying (GE).MethodsEighty-five patients were studied. GE parameters, including those in the overall and proximal stomach, were measured by GE functional tests at the Department of Nuclear Medicine. Autonomic nervous function was tested by spectral analysis of heart rate variability (HRV). The vagal activity and sympathetic activity were analyzed by recording the power in the high-frequency component (HF), low-frequency component (LF), and LF/HF ratio.ResultsOverall and proximal GE were delayed in 47.2% and 50.9% of the patients, respectively. Spectral analysis of HRV showed that the HF in patients with delayed proximal GE was significantly lower and that the LF/HF ratio was significantly higher than those in patients with normal proximal GE after a meal.ConclusionDelayed proximal GE might be caused by disrupted sympathovagal balance as a result of decreased vagal activity after a meal. Improvement in vagal activity may constitute an effective treatment method for patients with FD.