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Abstract
Gastric dysrhythmias, such as tachy- or bradygastria, have been reported in patients with functional dyspepsia (FD), but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG) studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume) or 300 ml (high volume) water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4%) reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1%) presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%). Following the high volume meal, 7 patients (50%) had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0%) was similar (P>0.20) to that in those without symptoms (88.5%; 75.0-100.0%). We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotility-like FD.
Highlights
Functional dyspepsia is a common clinical condition defined by pain or discomfort centered in the upper abdomen, which is not explained by any identifiable structural or biochemical abnormality [1,2]
The present study shows that the postprandial symptoms of upper abdominal discomfort and bloating elicited by the ingestion of a relatively low calorie test meal with increasing volumes of water in patients with dysmotility-like functional dyspepsia are not associated with abnormalities in gastric myoelectrical activity revealed by cutaneous EGG
We have reported that controlled distension of the stomach with a plastic bag positioned in the gastric fundus produced instability of gastric myoelectrical rhythm at high distension volumes (480-600 ml), which were associated with symptoms of upper abdominal discomfort and nausea [18]
Summary
Functional dyspepsia is a common clinical condition defined by pain or discomfort centered in the upper abdomen, which is not explained by any identifiable structural or biochemical abnormality [1,2]. A number of studies have shown that patients with this condition may have disordered gastric motility [3,4,5,6,7,8,9,10,11], but the relationships between these gastrointestinal motor abnormalities and symptoms in functional dyspepsia are poorly understood. Disturbances of gastric myoelectrical activity have been described in patients with functional dyspepsia presenting symptoms suggestive of motility disorders of the upper gastrointestinal tract [3,4,5,15,16,17]. The origin of these disturbances and the role of gastric dysrhythmias in symptom production in functional dyspepsia are unclear
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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