Regional differences of the stomach in the motor and sensory response to gastric distension and the role of simultaneous distending stimuli

Abstract

Background: [inputted gastric accommodation, wltb redistribution of the meal to the distal stomach, }*as been imphcated m the pathogenesis of functional dyspepsia symptoms. However, it rentains unclear Which part of the stomach is responsible for symptom generation. Recent studies suggest differential sensitivities of each region, but simukaneons barostat studies have not been pertbrmed The aim of the present study was to investigate the effect at separate and simukaneous bamstat distention of proximal and distal stomach in man. Methods: In 11 beahby volunteers (10 males: age 29• 1 years), a long tube assembly was placed through the py!orus Two bamstat balloons were attached to the tube at distances ensuring location irt the proximal and distal stomach Stepwise isobanc distentiorts of either bag were perfonned in a randomized order. VAt scores at each distending step assessed intensity of discomior~, balhress, bloating, nausea, belching, epigastric burning and satiety Distentions were pe~tormed with or without background distentim~ of the other bag at MDP + 2mmHg Finally, accommodation of the proxin*al stomach was assessed alter ingestion of a liquid meal w*th background antraI distention. Resnhs: The distal stomach had s*gnificandy lower compliance (56 • 4 vs 93 • 6 mUmmHg; p<0.001) Pressures and corresponding volumes at perception threshold d*d not differ between proximal and distal stomach (4 • 1 vs, 5 • 1 mmHg, 213 • (54vs. 219 • 66 mL; NS). At diseomtort threshold, pressures were not slgnflcantly different (12 • 2vs. 14 • 2mmHg, NS) but corresponding distal stomach volumes were slgndtcantly lower (959_+. 89 vs. 651 • 71 nil.; p<0.001) Perception scores and severity of individuaI symptoms at tim same distending pressures did not differ between the proximal and distal stomach. Backgeound distention did not significantly affect the pressures and the corresponding volumes at the thresholds tar perception and tbr discomfort, Conclusions: The sensi i*`aty to distension and the symptoms reduced bydistensmns do not differ between the proximal and distal stomach in man A low level of simultaneous distension does not modiI} 9 the percepuon of gastric distension.