Relationship between Symptoms and Gastric Emptying of Solids in Functional Dyspepsia

Abstract

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.

Rome III functional dyspepsia subdivision in PDS and EPS: recognizing postprandial symptoms reduces overlap

“…4,5 Although population-based studies found a good separation between PDS and EPS, patient samples showed up to 50% overlap between both, thereby limiting the usefulness of this subdivision in clinical practice. [10][11][12][13][14][15][16][17][18][19][20] In this study, we confirmed the major overlap between EPS and PDS in a group of 199 consecutive newly diagnosed FD patients. We evaluated in detail the relationship of symptoms to meal ingestion, and this revealed a high proportion of postprandially occurring non-PDS symptoms (epigastric pain and nausea) in the overlapping EPS-PDS group, compared with the pure EPS group.…”

“…Consistent with the presumed heterogeneity of FD, the ROME III consensus proposed to subdivide patients into two categories: meal‐related PDS symptoms including postprandial fullness and early satiation; and meal‐unrelated EPS symptoms characterized by epigastric pain and epigastric burning . Although population‐based studies found a good separation between PDS and EPS, patient samples showed up to 50% overlap between both, thereby limiting the usefulness of this subdivision in clinical practice …”

“…In support of the EPS‐PDS subdivision, population‐based studies found a good separation between PDS and EPS . In contrast, in clinic samples, overlap of PDS and EPS was found in up to 50% of the patients, and it is evident that this significantly impacts on the usefulness of the subdivision . In addition, the Rome III subdivision separated belching and nausea from FD symptoms into separate categories of belching and nausea/vomiting disorders .…”

“…[10][11][12][13][14] In contrast, in clinic samples, overlap of PDS and EPS was found in up to 50% of the patients, and it is evident that this significantly impacts on the usefulness of the subdivision. [15][16][17][18][19][20] In addition, the Rome III subdivision separated belching and nausea from FD symptoms into separate categories of belching and nausea/vomiting disorders. 5 Here again, major overlap with EPS and PDS could be found.…”

Duodenal rather than antral motility contractile parameters correlate with symptom severity in gastroparesis patients

“…Our literature review suggests this is the first study to demonstrate a strong correlation between symptoms and a motility parameter in gastroparesis using a duodenal—rather than gastric—motility measurement. Past studies have been limited to analysis of transit times such as gastric emptying by GES and have shown poor correlation with upper GI symptoms (15–17). In this study, we observed significant negative correlations, such that decreased contractile motility corresponded to increased symptom severity.…”