Comparison of Gastric Relaxation and Sensory Functions between Functional Dyspepsia and Healthy Subjects Using Novel Drinking-Ultrasonography Test

Abstract

Background: Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD includes impaired fundic accommodation, delayed gastric emptying and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients. Method: Subjects were 20 healthy volunteers and 26 successive FD patients according to the Rome III criteria. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. Results: The mean cross-sectional area of the fornix after 800 ml of water intake was significantly lower in the FD group compared with the control group. In the FD group, marked abdominal symptoms developed immediately after initiation of water intake, and VAS score differed significantly (p <0.01) between the control and FD groups at each time point. Conclusion: We developed the novel drinking-ultrasonography test which revealed abnormalities in gastric accommodation and sensation in patients with FD compared with healthy controls. This approach can be readily performed and allows the simultaneous evaluation of gastric accommodation, emptying and sensation.

Emerging treatments in neurogastroenterology: Acotiamade, a novel treatment option for functional dyspepsia

“…Among the patients with FD, anxiety disorders as well as gastric emptying are associated with impaired accommodation, while gastric emptying is also associated with accommodation . Combination subjective symptom scaling using a visual analog scale and ultrasonography during a drinking test has also been reported as an effective and non‐invasive evaluation and classification method for patients with FD …”

“…28 Combination subjective symptom scaling using a visual analog scale and ultrasonography during a drinking test has also been reported as an effective and non-invasive evaluation and classification method for patients with FD. 29,30 A recent study using ultrasonography during a drinking test showed that acotiamide promotes both gastric emptying and accommodation. 31 In the study, 42 patients with Rome II-defined FD were randomized to receive either placebo or acotiamide 100 mg t.i.d.…”

Visceral hypersensitivity and electromechanical dysfunction as therapeutic targets in pediatric functional dyspepsia

“…In adults with FD, decreased gastric accommodation and abnormal gastric volumes are widely demonstrated using barostat [90,97,98] , ultrasound [99,100] , SPECT [80,101,102] , and MRI [83] . Accommodation defects have been reported in 40% of adults with FD as assessed by barostat and in 47% as assessed by SPECT [93,101] .…”

New Medical Approach to Functional Dyspepsia, from Core Symposium 3, Japan Gastroenterological Association 2015–2017

“…Using a novel drinkingultrasonography test [20] to assess gastric motility and sensory function of FD patients, Hata et al [21] examined 20 healthy volunteers and 26 successive FD patients according to the Rome III criteria and showed that the mean cross-sectional area of the fornix after the intake of 800 mL of water was significantly lower in the FD group than in the control group. In addition, in the FD group, marked abdominal symptoms developed immediately after the initiation of water intake and Visual Analogue Scale (VAS) scores differed significantly (p < 0.01) between the control and FD groups.…”