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Relationship between symptoms and ingestion of a meal in functional dyspepsia.
Gut 2008; 57(11):1495-503Gut

Abstract

BACKGROUND AND AIMS

A subset of functional dyspepsia (FD) patients report meal-related symptoms, possibly representing a pathophysiologically homogeneous subgroup. The aim of the present study was to establish the time-course of symptoms in relation to meal ingestion, and to assess the relationship between self-reported meal-related symptoms and pathophysiological mechanisms in FD.

METHODS

218 FD patients (149 women, mean (SEM) age 39 (1) years) filled out a symptom questionnaire, including meal-induced aggravation. All patients underwent a gastric emptying breath test with severity (0-4) scoring of six symptoms (pain, fullness, bloating, nausea, burning and belching) at each sampling (15 min interval for 4 h). In 129 patients, gastric sensitivity and accommodation were assessed by barostat.

RESULTS

The intensity of each FD symptom was significantly increased 15 min after the meal, compared with the premeal score, and remained elevated until the end of the measurement period (all p<0.05). The time-course of individual symptoms varied, with early peaks for fullness and bloating, intermediate peaks for nausea and belching, and late peaks for pain and burning. Meal-induced aggravation was reported by 79% of patients, and in these patients postprandial fullness, which peaked early, was the most intense symptom. In patients without self-reported meal-induced aggravation, epigastric pain, which had a delayed peak, was the most intense symptom and they had a lower prevalence of gastric hypersensitivity (27.5% vs 7.7%).

CONCLUSION

Meal ingestion aggravates FD symptoms in the vast majority of patients, with symptom-specific time-courses. Postprandial fullness is the most severe symptom in patients reporting aggravation by a meal, while it is pain in those not reporting meal-related symptoms.

Authors+Show Affiliations

Department of Internal Medicine, Division of Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18519430

Citation

Bisschops, R, et al. "Relationship Between Symptoms and Ingestion of a Meal in Functional Dyspepsia." Gut, vol. 57, no. 11, 2008, pp. 1495-503.
Bisschops R, Karamanolis G, Arts J, et al. Relationship between symptoms and ingestion of a meal in functional dyspepsia. Gut. 2008;57(11):1495-503.
Bisschops, R., Karamanolis, G., Arts, J., Caenepeel, P., Verbeke, K., Janssens, J., & Tack, J. (2008). Relationship between symptoms and ingestion of a meal in functional dyspepsia. Gut, 57(11), pp. 1495-503. doi:10.1136/gut.2007.137125.
Bisschops R, et al. Relationship Between Symptoms and Ingestion of a Meal in Functional Dyspepsia. Gut. 2008;57(11):1495-503. PubMed PMID: 18519430.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between symptoms and ingestion of a meal in functional dyspepsia. AU - Bisschops,R, AU - Karamanolis,G, AU - Arts,J, AU - Caenepeel,P, AU - Verbeke,K, AU - Janssens,J, AU - Tack,J, Y1 - 2008/06/02/ PY - 2008/6/4/pubmed PY - 2008/12/25/medline PY - 2008/6/4/entrez SP - 1495 EP - 503 JF - Gut JO - Gut VL - 57 IS - 11 N2 - BACKGROUND AND AIMS: A subset of functional dyspepsia (FD) patients report meal-related symptoms, possibly representing a pathophysiologically homogeneous subgroup. The aim of the present study was to establish the time-course of symptoms in relation to meal ingestion, and to assess the relationship between self-reported meal-related symptoms and pathophysiological mechanisms in FD. METHODS: 218 FD patients (149 women, mean (SEM) age 39 (1) years) filled out a symptom questionnaire, including meal-induced aggravation. All patients underwent a gastric emptying breath test with severity (0-4) scoring of six symptoms (pain, fullness, bloating, nausea, burning and belching) at each sampling (15 min interval for 4 h). In 129 patients, gastric sensitivity and accommodation were assessed by barostat. RESULTS: The intensity of each FD symptom was significantly increased 15 min after the meal, compared with the premeal score, and remained elevated until the end of the measurement period (all p<0.05). The time-course of individual symptoms varied, with early peaks for fullness and bloating, intermediate peaks for nausea and belching, and late peaks for pain and burning. Meal-induced aggravation was reported by 79% of patients, and in these patients postprandial fullness, which peaked early, was the most intense symptom. In patients without self-reported meal-induced aggravation, epigastric pain, which had a delayed peak, was the most intense symptom and they had a lower prevalence of gastric hypersensitivity (27.5% vs 7.7%). CONCLUSION: Meal ingestion aggravates FD symptoms in the vast majority of patients, with symptom-specific time-courses. Postprandial fullness is the most severe symptom in patients reporting aggravation by a meal, while it is pain in those not reporting meal-related symptoms. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/18519430/Relationship_between_symptoms_and_ingestion_of_a_meal_in_functional_dyspepsia_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&amp;pmid=18519430 DB - PRIME DP - Unbound Medicine ER -