Maximum tolerated volume in drinking tests with water and a nutritional beverage for the diagnosis of functional dyspepsia

Montaño-Loza, Aldo J.; Schmulson, Max; Zepeda-Gómez, Sergio; Remes-Troche, José María; Valdovinos-Díaz, M.A.

doi:10.3748/wjg.v11.i20.3122

Cited by 18 publications

(20 citation statements)

References 40 publications

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“…31,32 Given all these observations, it seems that the response to a meal is of importance in the pathophysiology of IBS. Meal challenge tests have previously been used to study symptoms and pathophysiology in functional dyspepsia, [33][34][35] but so far, few studies have used a standardized meal test to assess meal-induced symptoms in a large IBS population. Our aim was therefore to determine and evaluate the GI symptom response to a standardized meal challenge in IBS.…”

Section: Introductionmentioning

confidence: 99%

Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls

et al. 2013

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Background: Patients with irritable bowel syndrome (IBS) often complain of worsening of symptoms after meal intake. Meal challenge tests have previously been used to study symptoms and pathophysiology in functional dyspepsia. Objective: The objective of this article is to evaluate differences in gastrointestinal (GI) symptom response to a standardized meal test in IBS compared to healthy controls. Methods: We included 67 patients with IBS and 16 healthy controls. After an overnight fast the subjects were served breakfast (540 kcal; 36% fat, 15% proteins, 49% carbohydrates; 8.9 g fiber). They completed visual analog scales assessing severity of six GI symptoms (abdominal pain, bloating, discomfort, nausea, gas, fullness) before breakfast and every 30 minutes up to 240 minutes after breakfast. The patients also completed a questionnaire (IBS-SSS) to assess IBS symptom severity during the preceding week. The course of symptom scores over time was analyzed using mixed models. Results: The meal was well tolerated and all subjects completed the test period. In patients, significant effects of time (initial increase to a maximum, followed by a return to baseline) were found for fullness, bloating, nausea and discomfort (all p values < 0.01 for linear, quadratic and third-order effect of time). In IBS patients, an independent significant association between IBS-SSS scores and all postprandial symptoms, except for nausea, was found (all p < 0.01). In controls, a significant linear, quadratic and third-order effect of time (all p < 0.0001) was found for fullness only. The difference in time course for bloating and discomfort between IBS patients and controls was confirmed when comparing the groups directly (significant time-by-group interaction effects, all p < 0.05), but not for nausea. On average, IBS patients scored significantly higher than controls on all symptoms, except for nausea (significant main effects of group, all p < 0.05). Conclusions: A standardized meal test seems to be a promising tool to study the symptom pattern in IBS and potentially to follow the effect of interventions.

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Section: Introductionmentioning

confidence: 99%

Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls

et al. 2013

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“…The second method, known as rapid water loading, involves the subject drinking water ad libitum over a 3-5 min period until full [19,20]. Water volumes consumed during the water load test have been shown to differ between patients with FD and healthy controls in both adults and children [21,22].…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Meal and Water Loading on Heart Rate Variability in Children with Functional Dyspepsia

et al. 2009

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“…First, the volume of nutrient drink causing maximum satiety in previously reported studies ranged from 361 to 562 mL in patients with FD. 7,13,20,21 Second, we considered that people usually tend to stop eating food before they reach maximal satiety. Maximal satiety is the worst possible level of unpleasant sensation, and so does not allow the quantification of dyspeptic symptoms.…”

Section: Discussionmentioning

confidence: 99%

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

Lim

Choi

Baeg

et al. 2014

J Neurogastroenterol Motil

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Background/AimsThe drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop a novel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). MethodsA novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was defined as responder. ResultsTotal aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1 ± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symptom scores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas did not in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspeptic symptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r = 0.480, P ＜ 0.001). ConclusionsOur novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FD patients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effects of novel therapies on postprandial symptoms.

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Maximum tolerated volume in drinking tests with water and a nutritional beverage for the diagnosis of functional dyspepsia

Abstract: A drinking test with water or a nutritional beverage can discriminate between FD patients and healthy subjects in Mexico, with high sensitivity and specificity. These tests could be used as objective, noninvasive, and safe diagnostic approaches for FD patients.

Cited by 18 publications

References 40 publications

Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls

Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls

The Effect of a Meal and Water Loading on Heart Rate Variability in Children with Functional Dyspepsia

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

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