Abstract
[Background] Psychological stress is one of the strong triggers that induce gastric symptoms in functional dyspepsia. Previously we reported that in healthy subjects virtual stress induced increase of gastric volume and gastric hypersensitivity, which relate to the pathophysiology of functional dyspepsia. [Aim] We tested our hypothesis that psychological stress can induce excessive changes of gastric volume and sensation in functional dyspepsia than in healthy subjects. [Subjects & Methods] Nine functional dyspepsia non-consulters (FD) and 9 healthy subjects (HS) were recruited in this study. Virtual visual stress (VS) was loaded with a 3D roller coaster movie for 10 minutes by the head-mounted display. Gastric volume and compliance were measured by barostat technique during the virtual stress session. At the beginning and end of the VS session, gastric perception was evaluated by barostat bag distention, then 3 perception thresholds were defined (first sensation (F), discomfort (D), and pain (P)). Subjective gastric perception and stress sensation during the stress were evaluated on the gastric symptom questionnaires consisted of 7 graded ordinate scales. [Results] During VS, FD reported higher stress sensation than in HC (p=0.0163, ANOVA). VS induced gastric volume increase both in FD and in HS (p=0.001). However, the changes of gastric volume in FD were not different in HS (p=0.88, ANOVA). Basal gastric perceptional thresholds were significantly lower in FD than in HS (p<0.001). After VS session, gastric perceptional thresholds significantly decreased in both FD and HS (p<0.001 ANOVA, vs. basal thresholds). Nausea symptom was moderate but remarkably induced in FD during VS compared with HS. [Summary] Virtual stress remarkably reduced gastric perceptional thresholds in functional dyspepsia, which suggested that psychological stress induce gastric symptoms by enhancing gastric hypersensitivity. Effects of VS on gastric volume and perception in FD and HS
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