Disorder of autonomic nervous system and its vulnerability to external stimulation in functional dyspepsia

Abstract

To elucidate the role of autonomic nervous system in functional dyspepsia patients, we examined 24-h heart rate variability: the basal levels, responses after lunch, cold pressor and mental arithmetic tests, and the efficacy of an autonomic drug (tofisopam). The high-frequency component (HF: 0.15–0.40 Hz) and the ratio of HF to the low-frequency component (LF: 0.04–0.15 Hz; LF/HF ratio) were used as indicators of parasympathetic and sympathetic autonomic nervous system function. The HF component in the 24-h, daytime, and nighttime was low in 86.7%, 97.8%, and 66.7% of patients (n = 45) and the LF/HF ratio was high in 51.1%, 73.3%, and 26.6% of patients. Gastrointestinal symptom tended to be severe in patients with autonomic nervous system disorder (p = 0.085). The abnormal response in HF component after lunch occurred in 38.2% (13/34) of patients who revealed a greater tendency towards in indigestion score (p = 0.061). Delays in recovery to the basal autonomic nervous system level after stimulus of the cold pressor and the mental arithmetic tests occurred in parts of patients. Tofisopam partially improved autonomic nervous system dysfunction and abdominal pain/indigestion. Imbalanced autonomic nervous system function and vulnerability for recovery from external stimuli were observed in functional dyspepsia patients, which was associated with dyspeptic symptoms.

Epigastric pain syndrome accompanying pancreatic enzyme abnormalities was overlapped with early chronic pancreatitis using endosonography

“…( 4 – 6 ) Furthermore, the involvement of several other mechanisms has also been suggested, including duodenal hypersensitivity to the luminal contents, small bowel dysmotility, Helicobacter pylori ( H. pylori ) infection, ( 7 ) psychological disturbances ( 8 ) and central nervous system disorders. ( 9 , 10 ) Since FD patients, especially epigastric pain syndrome (EPS) patients, can be classified into heterogenic subgroups, the use of proton pump inhibitors in the treatment of EPS is controversial. ( 11 – 15 ) Previous study has reported an association between FD and pancreatic dysfunction.…”

Structural changes in gastric glial cells and delayed gastric emptying as responses to early life stress and acute adulthood stress in rats

“…Among various types of stress, childhood trauma such as sexual or physical abuse is significantly associated with abdominal symptoms via HPA axis activation in humans, particularly in adult FD patients [10][11][12][13][14][15]. In addition, imbalance in the ANS, namely increased sympathetic activity and decreased vagal activity, is associated with FD pathogenesis including dyspeptic symptoms [31,32]. Therefore, the present findings of histological changes in gastric EGC processes upon maternal separation (a well-established experimental model of early-life stress) may be in part a microscopic indicator of FD pathogenesis.…”

Upregulation of Gastric Norepinephrine With β-Adrenoceptors and Gastric Dysmotility in a Rat Model of Functional Dyspepsia

“…FD has been described as a multifactorial disease that involves the ENS and the CNS (Sahan et al 2018). It has been reported that FD patients manifest an imbalance of ANS function and vulnerability to recovery from external stimuli (Tominaga et al 2016). Automatic dysfunction, including that of the sympathetic and parasympathetic system, has been observed in patients with FD (Park et al 2001).…”