Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia

Tack, Jan; Caenepeel, Philip; Fischler, Benjamin; Piessevaux, Hubert; Janssens, Jozef

doi:10.1053/gast.2001.27180

Cited by 523 publications

(567 citation statements)

References 24 publications

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“…In an attempt to release this gas, these patients inadvertently swallow air, which accumulates in the hypopharynx or the stomach and is finally released by belching with a sense of relief 163 , thereby reinforcing the patients' conviction. The correlation between belching and epigastric fullness is supported by the fact that belching was more frequently reported by patients with functional dyspepsia with hypersensitivity to gastric distension 164 . Functional dyspepsia-associated belching usually resolves, or at least improves, with a clear pathophysiological explanation of the symptoms, and such oeso phageal belching (also called aerophagia) has been removed from the Rome IV definition of functional dyspepsia.…”

Section: Gas-related Symptomsmentioning

confidence: 89%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

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260

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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Section: Gas-related Symptomsmentioning

confidence: 89%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

Self Cite

260

247

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show abstract

“…36 Several studies have confirmed that, as a group, patients with functional dyspepsia have enhanced sensitivity to balloon distension of the proximal stomach. 12,35,[37][38][39][40] It is now clear that hypersensitivity to distension is present in only a subset of patients. 12,35,39,40 According to one large study, hypersensitivity of the proximal stomach was associated with symptoms of postprandial pain, belching, and weight loss, 12 but so far, other, smaller, studies failed to report significant associations of visceral hypersensitivity and the symptom pattern.…”

Section: Hypersensitivity To Gastric Distensionmentioning

confidence: 99%

“…12,35,[37][38][39][40] It is now clear that hypersensitivity to distension is present in only a subset of patients. 12,35,39,40 According to one large study, hypersensitivity of the proximal stomach was associated with symptoms of postprandial pain, belching, and weight loss, 12 but so far, other, smaller, studies failed to report significant associations of visceral hypersensitivity and the symptom pattern. 35,40 Recent studies indicate that not only the proximal stomach but also, and maybe more intensely, the distal stomach may be involved in symptom generation due to gastric distension.…”

Section: Hypersensitivity To Gastric Distensionmentioning

confidence: 99%

Pathophysiology and treatment of functional dyspepsia

2004

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“…The results of recent studies have drawn attention to visceral hypersensitivity [9][10][11][12][13][14][15][16] and gastric motility abnormalities 5,17-29 as important factors that have a direct impact on the occurrence of upper gastrointestinal symptoms. Moreover, the results of many previous studies in gastric motility abnormalities have identified a variety of abnormalities, including delayed gastric emptying, 4,17,18 adaptive relaxation disorder, 5 intragastric food distribution abnormalities, [19][20][21] postprandial antral dysmotility, 22 gastric electrical activity abnormalities, [23][24][25] decreased interdigestive migrating contractions, 26,27 and postprandial hypercontraction of the gastric fundus.…”

Section: Discussionmentioning

confidence: 99%