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In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity.
Gastroenterology. 2013 Sep; 145(3):566-73.G

Abstract

BACKGROUND & AIMS

Hypersensitivity to gastric distention, an important feature of functional dyspepsia, is assessed by stepwise balloon distention of the proximal stomach in fasting patients. However, symptoms of functional dyspepsia are often worse after a meal, so studies of postprandial balloon distentions might be more relevant. We compared the effects of fasting and postprandial stomach distention in patients with functional dyspepsia.

METHODS

Twenty healthy controls and 62 patients with functional dyspepsia participated in a gastric barostat study at Leuven University Hospital with graded isobaric distentions before and after a liquid meal. On a separate day, all patients underwent a gastric emptying breath test with assessment of postprandial severity of 6 different dyspeptic symptoms scored at 15-minute intervals for 4 hours. For each symptom, a meal-related severity score was obtained by adding all scores; the cumulative symptom score (CSS) was obtained by adding individual symptom severity scores.

RESULTS

In patients, but not in controls, postprandial sensitivity to balloon distention was significantly greater than fasting sensitivity. The CSS and individual symptom scores did not differ between patients with normal or hypersensitivity to fasting distention, but patients who were hypersensitive to postprandial distention had a significantly higher CSS, along with scores for postprandial fullness, bloating, and nausea (all P < .05). On multivariate analysis, hypersensitivity to postprandial distention was associated with hypersensitivity to fasting distention and with impaired accommodation to a meal.

CONCLUSIONS

Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia.

Authors+Show Affiliations

Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23702005

Citation

Farré, Ricard, et al. "In Functional Dyspepsia, Hypersensitivity to Postprandial Distention Correlates With Meal-related Symptom Severity." Gastroenterology, vol. 145, no. 3, 2013, pp. 566-73.
Farré R, Vanheel H, Vanuytsel T, et al. In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. Gastroenterology. 2013;145(3):566-73.
Farré, R., Vanheel, H., Vanuytsel, T., Masaoka, T., Törnblom, H., Simrén, M., Van Oudenhove, L., & Tack, J. F. (2013). In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. Gastroenterology, 145(3), 566-73. https://doi.org/10.1053/j.gastro.2013.05.018
Farré R, et al. In Functional Dyspepsia, Hypersensitivity to Postprandial Distention Correlates With Meal-related Symptom Severity. Gastroenterology. 2013;145(3):566-73. PubMed PMID: 23702005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. AU - Farré,Ricard, AU - Vanheel,Hanne, AU - Vanuytsel,Tim, AU - Masaoka,Tatsuhiro, AU - Törnblom,Hans, AU - Simrén,Magnus, AU - Van Oudenhove,Lukas, AU - Tack,Jan F, Y1 - 2013/05/20/ PY - 2012/07/21/received PY - 2013/05/09/revised PY - 2013/05/14/accepted PY - 2013/5/25/entrez PY - 2013/5/25/pubmed PY - 2013/11/13/medline KW - CI KW - CSS KW - FD KW - Gastric Accommodation KW - IBS KW - MDP KW - PDS KW - Postprandial Distress Syndrome KW - SPECT KW - Visceral Hypersensitivity KW - confidence interval KW - cumulative symptom score KW - functional dyspepsia KW - gastric half-emptying time KW - irritable bowel syndrome KW - minimal distending pressure KW - postprandial distress syndrome KW - single-photon emission computed tomography KW - t(1/2) SP - 566 EP - 73 JF - Gastroenterology JO - Gastroenterology VL - 145 IS - 3 N2 - BACKGROUND & AIMS: Hypersensitivity to gastric distention, an important feature of functional dyspepsia, is assessed by stepwise balloon distention of the proximal stomach in fasting patients. However, symptoms of functional dyspepsia are often worse after a meal, so studies of postprandial balloon distentions might be more relevant. We compared the effects of fasting and postprandial stomach distention in patients with functional dyspepsia. METHODS: Twenty healthy controls and 62 patients with functional dyspepsia participated in a gastric barostat study at Leuven University Hospital with graded isobaric distentions before and after a liquid meal. On a separate day, all patients underwent a gastric emptying breath test with assessment of postprandial severity of 6 different dyspeptic symptoms scored at 15-minute intervals for 4 hours. For each symptom, a meal-related severity score was obtained by adding all scores; the cumulative symptom score (CSS) was obtained by adding individual symptom severity scores. RESULTS: In patients, but not in controls, postprandial sensitivity to balloon distention was significantly greater than fasting sensitivity. The CSS and individual symptom scores did not differ between patients with normal or hypersensitivity to fasting distention, but patients who were hypersensitive to postprandial distention had a significantly higher CSS, along with scores for postprandial fullness, bloating, and nausea (all P < .05). On multivariate analysis, hypersensitivity to postprandial distention was associated with hypersensitivity to fasting distention and with impaired accommodation to a meal. CONCLUSIONS: Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/23702005/In_functional_dyspepsia_hypersensitivity_to_postprandial_distention_correlates_with_meal_related_symptom_severity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(13)00750-6 DB - PRIME DP - Unbound Medicine ER -