Abstract
BackgroundRecent studies reported that impaired proximal duodenal mucosa, assessed by duodenal biopsy, could play an important role in the development of dyspeptic symptoms. The aims of this study were (a) to develop a method to measure “in vivo” duodenal and jejunal baseline impedance (BI) and (b) to assess small bowel mucosal integrity in patients with functional dyspepsia (FD) and healthy controls (HC).MethodsWe recruited 16 patients with FD and 15 HC. All subjects underwent ambulatory duodeno-jejunal manometry combined with impedance (HRM/Z), BI were determined by measuring impedance immediately after the passage of nocturnal migrating motor complex (MMC) phase IIIs.ResultsThe number of MMC phase IIIs in FD was significantly lower than that in HC (2.6 ± 1.4 vs 4.8 ± 1.7, p < 0.001). The BI in patients was significantly lower than that in HC in D1(164.2 ± 59.8 Ω in FD and 243.1 ± 40.5 Ω in HC, p = 0.0061), D2 (191.2 ± 34.1 and 256.5 ± 91.4 Ω, p = 0.01), D3 (214.0 ± 76.9 and 278.1 ± 45.3 Ω, p = 0.009), D4 (270.8 ± 54.2 and 351.8 ± 50.2 Ω, p < 0.001), and J1 (312.2 ± 55.4 and 379.3 ± 38.3 Ω, p = 0.001).ConclusionsThis is the first study reporting the duodenal and jejunal BI in vivo. The results have shown significantly lowered BI in the proximal small intestine in patients with FD compared to HC. Furthermore it suggests that measurements of small bowel BI could be used as a biomarker for diagnosis and follow up of patients with FD.
Highlights
Functional dyspepsia (FD) is a disorder defined by Rome IV criteria as the presence of chronic bothersome early satiety, postprandial fullness, epigastric pain or burning without any organic, systemic or metabolic disease that is likely to explain the symptoms [1]
The results have shown significantly lowered baseline impedance (BI) in the proximal small intestine in patients with functional dyspepsia (FD) compared to healthy controls (HC)
Seven patients with FD were diagnosed by Rome IV criteria as postprandial distress syndrome (PDS) and 3 were epigastric pain syndrome (EPS), 6 were overlapping PDS and EPS characteristics
Summary
Functional dyspepsia (FD) is a disorder defined by Rome IV criteria as the presence of chronic bothersome early satiety, postprandial fullness, epigastric pain or burning without any organic, systemic or metabolic disease that is likely to explain the symptoms [1]. The authors suggested that impaired duodenal mucosal barrier function could facilitate the passage of luminal antigens through the epithelium, which may induce low-grade inflammation and would contribute to bothersome dyspeptic symptoms. Whether these mucosal abnormalities are restricted to the duodenum or they further affect the proximal small intestine is unknown. Recent studies reported that impaired proximal duodenal mucosa, assessed by duodenal biopsy, could play an important role in the development of dyspeptic symptoms. The aims of this study were (a) to develop a method to measure ‘‘in vivo’’ duodenal and jejunal baseline impedance (BI) and (b) to assess small bowel mucosal integrity in patients with functional dyspepsia (FD) and healthy controls (HC). All subjects underwent ambulatory duodeno-jejunal manometry combined with impedance (HRM/Z), BI were determined by measuring impedance immediately after the passage of nocturnal migrating motor complex (MMC) phase IIIs
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