M2011 Mechanisms of Burn-Induced Impairment in Gastric Slow Waves and Emptying in Rats

Abstract

Giovanni Sarnelli, Francesco De Giorgi, Elisabetta Atteo, Daniela Viscardi, LetiziaVozzella, Rosario CuomoBackground and aims: Functional bowel disorders may follow acute intestinal infection. Asingle, large, retrospective study showed that a subset of dyspeptic patients had a historyof gastroenteritis. No data are however currently available in patients with prospectivelyidentified postinfectious dyspepsia (PD). Our aim was to characterize frequency, symptomsevolution and underlying mechanisms of functional dyspepsia, up to 12 months after acutegastroenteritis. Subjects and Methods: A total of 150 consecutive patients with undergoingacute gastroenteritis were screened and followed-up for 1 month. In patients with symptomspersistence upper GI endoscopy, gastric emptying study (13C-octanoic acid breath test) andsatiety testing (as a surrogate of gastric fundus accommodation) were performed. Patternand severity of dyspeptic symptoms were scored at 3, 6 and 12 months by standardizedquestionnaire. Gastric emptying and satiety testing were repeated at 6 months. Patients withprevious diagnosis of FGIDs or organic disease at endoscopy were excluded. Cut-off valuesfor normal gastric emptying rate and meal-induced satiety (120 min and 890 kcal, respect-ively) were obtained on 20 age/sex matched healthy subjects. Results: At baseline no signsof infection by common pathogens were found in the majority of the patients, except thangiardia lamblia and salmonella tiphy in 3 and 1 patients, that were respectively treated andfollowed up. Persistence of dyspeptic symptoms at 1 month was observed in 31 subjects(18 male, age 28±10), with postprandial fullness, bloating, belching, nausea, epigastric pain,early satiety and vomiting being reported by 85, 70, 70, 56, 67, 48 and 19 % of the patients,respectively; systematic analysis revealed that such pattern of symptoms was quite stablealong the times. Although severity was gradually reducing for the majority of the symptoms,only the proportion of patients reporting moderate or severe belching were significantlyreduced at 12 months (70 vs. 12 %, p<0.05). At baseline, delayed gastric emptying andimpairedsatietytestingwerepresentin60%and85%ofthepatientswithasimilarpercentageat 6 months (58 and 90%, respectively). Conclusions: We showed that at least 20% ofprospectively evaluated patients with acute gastroenteritis develop and maintain dyspepticsymptoms after the resolution of the acute phase. In these patients symptoms severity wasgradually reducing, but still persistent up to 1 year. Persistent delayed gastric emptyingof solid meal and impaired gastric accommodation are putative mechanisms involved insymptoms generation.