Functional Dyspeptic Patients Research Articles

Normalization Effect of Both ST36 and CV11, 12, 13 Meridian Points on the Abnormal Gastric Myoelectrical Activity in Two Cases of Functional Dyspeptic Patients

Objectives: The aim of this study was to introduce the normalization effects of stimulation of both ST36 and CV11, 12, 13 meridian points on the abnormal gastric myoelectrical activity in two cases of functional dyspeptic patients with gastric dysmotility.Methods: Gastric myoelectrical activity was recorded by electrogastrography every two weeks until their gastric myoelectrical activity finally reached the normality. Dominant frequency of gastric slow waves in the fasting and postprandial periods and a dominant power ratio were obtained on each occasion. Patients were treated three times each day: 9 am, 1 pm, and 7 pm. The first treatment consisted of manual and immersion stimulation on all used meridian points for 20 min. In the second and third treatments, electrical stimulation of both ST36 was added. It was conducted for 20 min at a strength intensity of 1.2 times the pain threshold at a frequency of 3 Hz.Results: Stimulation of the above meridian points normalized abnormal gastric myoelectrical activity. The time taken to return from abnormal gastric myoelectrical activity to normal was 16-19 weeks.Conclusion: Stimulation of both ST36 and CV11, 12, 13 meridian points normalized the abnormal gastric myoelectrical activity in the functional dyspepsia of gastric dysmotility.

ASSOCIATION OF DUODENAL EOSINOPHILIC INFILTRATE WITH HELICOBACTER PYLORI INFECTION, BUT NOT WITH FUNCTIONAL DYSPEPSIA.

The role of Helicobacter pylori infection on eosinophilic infiltration in duodenal mucosa is poorly studied. An increase in the number of eosinophils in duodenum has been associated with functional dyspepsia. To evaluate the influence of H. pylori infection on duodenal eosinophil count and the role of eosinophilic infiltrate of duodenum in functional dyspepsia. Positive and negative H. pylori individuals were included. Both functional dyspeptic patients according to Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were enrolled. They were submitted to upper endoscopy and H. pylori infection was verified by gastric histopathology and urease test. Eosinophils in the duodenal mucosa were counted in five high-power fields, randomly selected on slides of endoscopic biopsies. Thirty-nine H. pylori positive (mean age 40.5 and 69.2% women) and 24 negative patients (mean age 37.3 and 75% women) were included. The influence of the infection was observed in the duodenal eosinophil count, which was higher in infected individuals: median 13.2 vs 8.1 in non-infected individuals (P=0.005). When we analyzed patients according to symptoms, cases - mean age 39.6; 71.4% women - and controls - mean age 38.7; 71.4% women - had similar duodenal eosinophil count: median 11.9 and 12.6 respectively (P=0.19). We did not demonstrate association of duodenal eosinophil count with functional dyspepsia but found association with H. pylori infection.

Frequency of helicobacter pylori in patients with functional dyspepsia.

To evaluate the frequency of Helicobacter pylori in individuals with functional dyspepsia. Study Design: Cross sectional descriptive study. Period: Six months from 01-May-2014 to 31-10-2014. Setting: Liaquat National Hospital, Karachi. Materials and Methods: All the patients between 18 to 70 years of age diagnosed as functional dyspepsia for more than 03 months duration were admitted and evaluated for Helicobacter pylori infection through histopathological examination. Results: Total 121 subjects with functional dyspepsia were screened for Helicobacter pylori infection. The mean ±SD for age of subjects with functional dyspepsia was 41.74±08.87. The mean age ±SD of Helicobacter pylori infected individuals was 40.70±7.82 while the mean ±SD of age in helicobacter pylori negative patients was 40.55±10.63. Majority of the subjects were out-patients, 30-39 years of age with male predominance. The most common duration of disease observed was 6-9 months with epigastric pain and burning the predominant symptoms. The Helicobacter pylori infection was observed in 78(64.4%) individuals, of which 55 were males and 23 were males (p=<0.01). Conclusion: The functional dyspeptic patients are prone to acquire Helicobacter pylori infection therefore present study reported 64.4% prevalence for H. pylori infection with male gender predominance.

The effect of Helicobacter pylori eradication on functional dyspepsia in Turkish children.

The aim of this study was to evaluate the effect of Helicobacter pylori (H.pylori) eradication on dyspepsia symptom scores in children with functional dyspepsia (FD). One hundred and fifty functional dyspeptic children (ages 8-18years, mean: 13.3±2.84years; 30% male) were enrolled to this prospective study. Upper gastrointestinal endoscopy was performed on all patients, and the samples from the gastric antrum and corpus were obtained for the existence of H.pylori. 13 Carbon-urea breath test was performed to evaluate the eradication therapy's efficacy. The symptoms were assessed at first visit and at the 8th week and 16th week. Forty-nine (33%) children were in the H.pylori-positive group, and 101 (67%) children were in the H.pylori-negative group. Dyspepsia symptom scores improved at 8th week in both groups (P<.05). Helicobacter pylori was eradicated in 30 patients (61%), while in the H.pylori-eradicated group, all dyspepsia symptoms' scores decreased, and in the H.pylori-uneradicated group, only three symptoms' scores decreased. Symptom scores were lower in H.pylori-eradicated group than H.pylori-uneradicated group. Although the tests used for the diagnosis of H.pylori in functional dyspeptic patients increased the cost of health care, the dyspepsia symptom scores decreased with the eradication therapy in a high prevalence community. The findings may differ in low prevalence communities where the diagnostic tests for H.pylori infection are not recommended in children in the absence of alarm signs or symptoms.

Mo1961 - Potential Role of Helicobacter Pylori Infection in Clinical and Laboratory Nutritional Parameters in Functional Dyspeptic Patients

Mo1961 - Potential Role of Helicobacter Pylori Infection in Clinical and Laboratory Nutritional Parameters in Functional Dyspeptic Patients

The association between adult-type hypolactasia and symptoms of functional dyspepsia.

Functional dyspepsia and lactose intolerance (adult-type hypolactasia, ATH) are common conditions that may coexist or even be confounded. Their clinical presentation can be similar, however, lactose intolerance does not form part of the diagnostic investigation of functional dyspepsia. Studies on the association between functional dyspepsia and ATH are scarce. This study aimed to evaluate whether ATH is associated with symptoms of functional dyspepsia. Patients fulfilling the Rome III diagnostic criteria for functional dyspepsia underwent genetic testing for ATH. Dyspeptic symptoms were evaluated and scored according to a validated questionnaire. The diagnostic criteria for ATH was a CC genotype for the -13910C/T polymorphism, located upstream of the lactase gene. The mean scores for dyspeptic symptoms were compared between patients with ATH and those with lactase persistence. A total of 197 functional dyspeptic patients were included in the study. Mean age was 47.7 years and 82.7% patients were women. Eighty-eight patients (44.7%) had a diagnosis of ATH. Abdominal bloating scores were higher in ATH patients compared to the lactase persistent patients (P=0.014). The remaining dyspeptic symptom scores were not significantly different between the two groups. The study results demonstrate an association between ATH and bloating in patients with functional dyspepsia.

Changes in serum ghrelin level in relation to meal-time in patients with functional dyspepsia.

Ghrelin is a peptide hormone that is involved in gastrointestinal motility and secretion; and therefore, may play a role in functional dyspepsia. To compare the change of serum ghrelin level in relation to meal-time, between patients with functional dyspepsia and a control group. In a cross-sectional study, 18 subjects with functional dyspepsia according to the Rome III criteria were enrolled in our study. Blood samples were collected five times: 30 minutes (min) before a standard breakfast; at the time as serving breakfast; and 30, 60 and 90 min after breakfast. Serum ghrelin concentration was measured in these patients and compared with eight normal individuals, as controls. The serum ghrelin level 30 minutes after breakfast was significantly higher in dyspepsia patients, compared to controls (751 ± 171.84 pg/ml versus 576.9 ± 195.62 pg/ml, p = 0.033). Although patients had a higher mean serum ghrelin level 30 minutes before, exactly at the time of serving breakfast and 60 min after breakfast there was no statistically significant difference between patients and controls. The shape of the curve was also different between the two groups, from 30 min until 90 min after breakfast, which is the time that most dyspeptic symptoms usually occur, although this difference was not significant (p > 0.05). The significantly different ghrelin levels between dyspeptic patients and the normal population showed that ghrelin may have an important role in inducing symptoms, in functional dyspeptic patients.

Association of moderate level of anxiety in functional dyspeptic patients attending out door general practice in teaching hospital Kathmandu

Association of moderate level of anxiety in functional dyspeptic patients attending out door general practice in teaching hospital Kathmandu

Alimentary factors in the development of gastric intestinal metaplasia in functional dyspeptic patients

Intestinal metaplasia of the stomach is a lesion in which metaplasia of gastric epithelial cells occurs for an intestinal phenotype. Gastric intestinal metaplasia is a lesion associated with an increase in the risk of gastric carcinoma development. Epidemiologic studies indicate a relation between dietary habits and stomach cancer development, some habits increasing the risk for it, and others have a protective effect, suggesting that antioxidants, such as vitamins A, C, and E, decrease the risk of this type of cancer. The relationship of these alimentary factors and intestinal metaplasia is unknown. It is a case-control, observational study in which 320 patients with functional dyspepsia, divided in two groups, were assessed. The case I group (individuals with intestinal metaplasia) had their dietary pattern compared to that of the control group, constituted of individuals similar to those in the case group but without intestinal metaplasia, through a food frequency questionnaire. The analysis of the dietary pattern of functional dyspeptic patients with intestinal metaplasia, and its comparison with those without intestinal metaplasia, showed a higher frequency of canned and smoked foods consumption in the first group and, on the other hand, a higher consumption of fruits and vegetables in patients without intestinal metaplasia. No effect of salt consumption was detected. The results obtained in this study suggest changes in the diet, with a decrease in the consumption of smoked and canned foods, and an increase in the consumption of fruits and vegetables, can lead to a diminution of gastric intestinal metaplasia cases.

Genetic Polymorphisms of Cytochrome P450 2C19 in Functional Dyspeptic Patients Treated with Cimetidine

Inter-individual pharmacokinetic variation of H2-receptor antagonist is related to genetic polymorphism of CYP2C19. We investigated the frequency of CYP2C19 genetic polymorphism and the treatment duration of cimetidine by CYP2C19 genotypes in functional dyspeptic patients without definite causes who were treated with cimetidine in Korea. One hundred subjects with functional dyspepsia participated in this study from March 1, 2010 to June 30, 2011. They were tested by upper gastrointestinal endoscopy and treated for their dyspepsia with cimetidine. The single nucleotide polymorphisms (SNPs) of CYP2C19 were genotyped using the Seeplex CYP2C19 ACE Genotyping system. There were no significant differences in the demographic, clinical, or laboratory findings among the CYP2C19 subgroups which are wild type homozygote (W/W), heterozygote (W/V), and variant homozygote (V/V). The frequencies of CYP2C19 subgroups were 33 (33%) in W/W, 49 (49%) in W/V, and 18 (18%) in V/V, respectively. The mean duration of cimetidine treatment (in weeks) was the shortest in the V/V among the CYP2C19 genotypes (W/W: 5.1±1.5, W/V: 4.0±1.7, V/V: 2.1±0.7; p<0.001). This study can also act as a basis for further investigation to identify the underlying genetic, epigenetic, or environmental factors in CYP2C19 enzyme activity.

Effect of mianserin on gastric sensorimotor function and gastric emptying: a randomized, placebo‐controlled, double‐blind, crossover study in healthy volunteers

Antidepressants such as mianserin can improve symptoms in some functional dyspeptic patients but their mechanism of action remains unclear. We aimed to assess the effects of mianserin on gastric sensorimotor function in man. In this randomized, placebo-controlled, double-blind, crossover study 12 healthy subjects (six men) underwent a gastric barostat study and a gastric emptying breath test after 7 days pretreatment with placebo or mianserin (20 mg; p.o.). Graded isobaric and isovolumetric distentions were performed to determine gastric compliance and sensitivity. Subsequently, intrabag pressure was held constant and the volume increase after administration of a liquid meal (200 mL; 300 kcal) was studied. Breath was sampled before and after ingestion of a test meal and half-emptying times for solids and liquids were determined from the breath samples. Mianserin was compared to placebo using t-tests and mixed model analysis (mean ± SD). Mianserin did not affect pressures or volumes needed to induce first perception or discomfort. During isovolumetric distensions compliance was decreased after mianserin treatment (1.8 ± 0.4 vs 2.0 ± 0.3 mmHg 100 mL(-1); P < 0.05). Premeal volumes were comparable in both treatment arms (221 ± 99 vs 220 ± 88 mL), but meal-induced relaxation during the first 30 min was significantly inhibited after mianserin treatment (F(6,40) = 2.58, P < 0.05). Mianserin did not affect either solid or liquid gastric emptying. Mianserin does not alter gastric emptying rate or sensitivity to gastric distension, but inhibits gastric accommodation to a meal in its early phase. These observations provide no explanation for the effects of mianserin in functional dyspeptic patients.

Gastric reddish streaks in the intact stomach: Endoscopic feature of reactive gastropathy

The pathogenesis of reddish streaks in the intact stomach is unclear. Sixty-three functional dyspeptic patients with gastric reddish streaks were recruited for the study. Fifty-five patients (group I) had only reddish streaks while nine patients (group II) had additional lesions such as reddish patches or spots randomly scattered throughout the stomach. Updated Sydney system and parameters of reactive gastropathy were used to score the biopsy specimens from reddish streaks separately. Helicobacter pylori infection rate was found to be markedly lower in group I than group II patients (13% vs 89%, P < 0.001). H. pylori-infected patients had higher scores for acute and chronic inflammation (P < 0.001) and foveolar hyperplasia (P < 0.005) than non-infected patients, while other parameters for gastritis and gastropathy were similar between infected and non-infected patients. In H. pylori-non-infected patients all biopsy specimens had at least one histological feature of reactive gastropathy. Bile reflux was observed in 54% of patients (34/63). Only 7.9% used non-steroidal anti-inflammatory drugs and 4.9% drank alcohol. The present data indicate that the fundamental histological features of gastric reddish streaks are reactive gastropathy with low H. pylori infection, and are probably enterogastric reflux related in etiology. Coincidental H. pylori infection increased acute and chronic inflammatory cell infiltration, and enhanced the grade of foveolar hyperplasia.

Psychosocial-spiritual factors in patients with functional dyspepsia: a comparative study with normal individuals having the same endoscopic features

The aim of the study is to identify factors that are associated with dyspeptic symptoms in patients with functional dyspepsia (FD) in a multivariate context. Demographic data, personal habits, stressful life events, and psychological distress were compared between functional dyspeptic patients with gastric reddish streaks and asymptomatic counterparts who underwent upper gastrointestinal endoscopy as part of a self-paid physical check-up. There were 93 patients in the symptomatic group and 67 patients in the asymptomatic group. FD patients had a lower proportion of tea consumption (38 vs. 61%, P = 0.004), more were single (20 vs. 6%, P<0.05), less belief in religion (46 vs. 66%, P<0.05), a greater number (median+/-interquartile range, 3.0+/-2.0 vs. 2.0+/-2.0, P<0.001) and more severity (1.5+/-0.9 vs. 1.0+/-1.0, P<0.001) with regard to stressful life events, greater scores of symptom dimensions of somatization, depression, anxiety, and psychotism and general severity index of psychopathology as compared with asymptomatic counterparts. Only tea consumption [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.15-0.72, P<0.01)], religion (OR = 0.42, 95% CI = 0.19-0.91, P<0.05), number of stressful life events (OR = 2.74, 95% CI = 1.28-5.88, P<0.01), and somatization (OR = 6.80, 95% CI = 1.21-38.08, P<0.05) remained statistically significant in multivariate analysis. FD with gastric reddish streaks exhibited increased somatization, more stressful life events, less belief in religion, and less tea consumption as compared with asymptomatic counterparts. The findings of the study suggest the importance of adopting a more comprehensive holistic bio-psycho-socio-spiritual model when dealing with FD patients.

The Prevalence of Occult Celiac Disease among Patients with Functional Dyspepsia: A Study from the Western Region of Iran

Objective. The prevalence of Celiac Disease (CD) is high in Iran, and evaluation of CD is not part of the routine screening procedure for dyspeptic patients; therefore, cases of occult CD may be missed. This study aimed to investigate the prevalence of occult CD among dyspeptic patients who presented at a gastroenterology clinic in the Western region of Iran. Methods. In this descriptive, cross-sectional prospective study, patients who had a history of at least 12 weeks of upper abdominal discomfort were eligible to participate in the study during a 14-month recruitment period. Patients with a clinical or paraclinical data in favor of organic causes were excluded from the study. Enrolled patients were screened for IgA antiendomysium antibody (EMA) and IgA antitissue transglutaminase antibody (tTG). Those who screened positive for EMA/tTG received a confirmatory diagnostic biopsy for Marsh classification of CD. Results. From 225 potential participants with dyspepsia, 55 patients were excluded due to having explainable organic causes. The study sample included 170 patients with “functional dyspepsia.” Mean age of participants was 31 years and 55.8% were female. Twelve patients (7%) had positive tests (EMA/tTG), of which 10 were female (83.4%). According to Rome II criteria, all twelve patients with positive tests had “dysmotility type dyspepsia.” Based on Marsh classification, six patients were consistent with “Marsh I,” four with “Marsh II,” and two with the “Marsh III” classification. Conclusions. In this study, the prevalence of CD in dyspeptic patients was high. As a result, this study suggests that screening by serology tests (EMA/tTG) is justifiable for the detection of CD among functional dyspeptic patients in the tertiary centers in our country.

Detection of patients with functional dyspepsia using wavelet transform applied to their electrogastrogram

The aim of the present study was to develop a classifier able to discriminate between healthy controls and dyspeptic patients by analysis of their electrogastrograms. Fifty-six electrogastrograms were analyzed, corresponding to 42 dyspeptic patients and 14 healthy controls. The original signals were subsampled, filtered and divided into the pre-, post-, and prandial stages. A time-frequency transformation based on wavelets was used to extract the signal characteristics, and a special selection procedure based on correlation was used to reduce their number. The analysis was carried out by evaluating different neural network structures to classify the wavelet coefficients into two groups (healthy subjects and dyspeptic patients). The optimization process of the classifier led to a linear model. A dimension reduction that resulted in only 25% of uncorrelated electrogastrogram characteristics gave 24 inputs for the classifier. The prandial stage gave the most significant results. Under these conditions, the classifier achieved 78.6% sensitivity, 92.9% specificity, and an error of 17.9 +/- 6% (with a 95% confidence level). These data show that it is possible to establish significant differences between patients and normal controls when time-frequency characteristics are extracted from an electrogastrogram, with an adequate component reduction, outperforming the results obtained with classical Fourier analysis. These findings can contribute to increasing our understanding of the pathophysiological mechanisms involved in functional dyspepsia and perhaps to improving the pharmacological treatment of functional dyspeptic patients.

Helicobacter pylori eradication therapy in nonulcer dyspepsia is beneficial

Non-ulcer dyspepsia (NUD) is a common condition, and no therapy is dramatically effective in treating this disorder. It is therefore vital that there should be a reliable evidence for the efficacy of treatments prescribed to NUD patients. This updated systematic review suggests that H. pylori eradication has a small but statistically significant benefit in treating NUD. One-half of the world's population has Helicobacter pylori (H. pylori) infection, with an estimated prevalence of 30% in North America[1–2] compared with a prevalence of 80–90% in the developing world.[3] The annual incidence of new H. pylori infections in industrialized countries is approximately 0.5 per 100 persons of the susceptible population compared with three or more per 100 persons in the developing countries.[4,5] In southern part of Saudi Arabia, H. pylori was present in 81% of nonulcer dyspepsia (NUD) patients (with normal esophago-gastroduodenoscopy [EGD]) reported[6] in 1993, but a recent report[7] after 11 years (2004) from the same area, showed a significant reduction (53%) in the incidence of H. Pylori. This reduction is most likely secondary to improved socioeconomic and hygienic conditions, in addition to widespread treatment of H. Pylori in dyspepsia patients. Risk factors for acquiring H. pylori infection include residence in a developing country, poor socioeconomic conditions, family overcrowding, and possibly an ethnic or genetic predisposition. Dyspeptic symptoms affect 15–40% of the adult population in the western world.[8] Most affected individuals do not have structural or biochemical alterations that could explain these symptoms and, thus, are classified as having nonulcer or functional dyspepsia.[9] The pathophysiology of NUD is poorly understood; it may be associated with changes in motility, secretion, or sensitivity of the digestive tract.[10–12] Data from epidemiological studies are controversial in terms of the association of H. pylori with NUD symptoms.[13–15] Clinical studies focusing on the symptomatic benefits of eradicating H. pylori infections in patients with NUD have yielded conflicting results.[16,17] The majority of these studies were performed in low-prevalence H. pylori infection populations. [18–22] There are few studies reporting the consequences of eradicating these bacteria in infected functional dyspeptic patients in high-prevalence populations. Brazil is a country with a high H. pylori prevalence, with 60–87% of the adult population being infected with the bacteria.[23–25] H. pylori infection is the main cause of peptic ulcer and eradication therapy successfully cures this chronic relapsing and remitting disease.[26] This discovery has made an enormous difference to patients with peptic ulcer disease, but this accounts for only 5–10% of the population that has dyspepsia.[27] The majority of patients with dyspepsia have a normal endoscopy and in the absence of predominant reflux symptoms these patients are defined as having NUD.[28] The pathogenesis of this condition is uncertain and is likely to be multifactorial. H. pylori infection may have a role in this disorder, as the organism causes a chronic inflammatory response and has effects on gastric acid secretion.[29] The effect of H. pylori eradication therapy on NUD symptoms has been evaluated in several large, well designed, randomized controlled trials (RCTs).[30] Systematic reviews of RCTs can be a powerful method of assessing the effectiveness of a therapy. Unfortunately, many high-quality systematic reviews have been published with differing conclusions. This review aims to show that H. pylori eradication is beneficial and cost-effective in the treatment of NUD.

Impaired drinking capacity in patients with functional dyspepsia: intragastric distribution and distal stomach volume

The water drink test is a good tool to evoke dyspeptic symptoms. To what extent these symptoms are related to altered gastric distribution is not clear. Therefore, we determined gastric volumes after a drink test using SPECT. After a baseline scan 20 healthy volunteers (HV) and 18 patients with functional dyspepsia (FD) underwent a drink test (100 mL min(-1)) followed by five scans up to 2 h. Dyspeptic symptoms were scored before every scan. A Wilcoxon signed rank test (P < 0.05) and a mixed effects model were used for statistical analyses. Fasting volumes were significantly higher in FD compared to HV for total, proximal and distal stomach (P < 0.001). Functional dyspeptic patients ingested significantly less water (P < 0.001) and had an impaired filling of the distal part of the stomach (P = 0.001) after the drink test. In FD, bloating (prox. 80%, dist. 56%), pain (prox. 87%, dist. 62%) and fullness (prox. 80%, dist. 59%) were determined more by proximal stomach volume rather than distal stomach volume. These data suggest that drinking capacity is mainly determined by antral volume, with a reduced antral filling in FD compared to HV. The persisting symptoms of bloating, pain and fullness in FD are predominantly associated with proximal stomach volume.

Flexible Coping Psychotherapy for Functional Dyspeptic Patients: A Randomized, Controlled Trial

This study tested the efficacy of a new psychotherapy, flexible coping psychotherapy (FCP), specifically designed for enhancing coping flexibility of patients with functional dyspepsia (FD). The design of this psychotherapy is based on the general cognitive-behavioral model and previous findings on FD. We adopted a randomized, controlled design to examine the differences between the target (FCP) and control (supportive psychotherapy [SPP]) conditions. Coping flexibility and outcome measures reported by 75 Chinese FD patients (18-65 years; 35% men) were assessed before and 12 months after treatment. Results revealed that participants who received the FCP reported an increase in coping flexibility as well as reductions in self-rated dyspeptic symptom severity (SDSS), gastroenterologist-rated dyspeptic symptom severity, and anxiety levels (p values <.01). Participants who received the SPP reported reductions in SDSS and anxiety levels (p values <.0001). Although both groups reported a decrease in SDSS, only the SDSS level of the FCP group was comparable to that of a healthy community sample (p = .28). These findings suggest that FCP is a potentially effective intervention for treating FD symptoms. Its effectiveness may be attributable to the specific components of FCP rather than common psychotherapeutic factors such as emotional support and empathy per se.

Dispepsia funcional e depressão como fator associado

To assess the association between depression and functional dyspepsia. Three hundred and forty eight dyspeptic patients were included in a cross-sectional study in the gastroenterology outpatient clinic of a University Hospital in southern Brazil (Pelotas, RS) within a 1-year period (from March, 2001 to March, 2002). The assessment of depression occurred after the diagnosis of dyspepsia. The presence (or not) of depression was verified in both functional and organic dyspeptic patients. In a second moment, the results were compared, an univariate analysis was used to describe the frequencies of the interest variables and a chi-square for the comparison between proportions of the categorical variables. The logistic regression technique was used to establish the odd of functional dyspeptic patients to present depression and to control the effect of other variables in the outcome variable Showed greater prevalence of depression among functional dyspepsia patients (30,4%), when compared to organic dyspepsia patients (11,2%). Women showed greater risk to present functional dyspepsia (OR: 1,74, IC 95%, 1,05-2,89) and in terms of age, the group with ages between 31 to 50 years (OR: 0,28 IC 95%, 0,13-0,54) and 51 to 60 years (OR: 0,41, IC 95%, 0,17-0,96) showed protection effect (subjects within this age groups have minor risk to present functional dyspepsia). After the multivariate analysis depressed patients showed three times greater comorbidity with functional dyspepsia when compared to non-depressed patients (OR 3, 13; IC 95%; 1, 71-5, 74). The adjustment for the gender, age and marital status variables confirmed the association between functional dyspepsia and depression. Results point the need to assess the presence of depression in functional dyspepsia patients and to establish specific treatment strategies for these patients.

Partial Gastric Volumes and Upper Abdominal Sensations in Functional Dyspeptic and GERD Patients: A 3D Ultrasonographic Study

The aim of the study was to evaluate the change in proximal and distal gastric volumes after ingestion of a nutrient drink and its relationship to upper abdominal sensations using three-dimensional ultrasonography. Fifty FD patients, 20 GERD patients patients and 35 healthy controls participated. Partial gastric volumes and sensations were assessed while fasting and after ingestion of a nutrient drink (500 mL, 300 kcal). Division of partial gastric volumes by total gastric volume was used to calculate proximal and distal gastric volume ratios. The proximal gastric volume ratio was smaller in FD patients and larger in GERD patients compared to controls (p < 0.001 and p= 0.008, respectively). FD patients with impaired proximal relaxation (46%) had a larger increase in distal gastric volume (p= 0.008) and higher fullness sensations (p= 0.027) compared to FD patients with normal proximal relaxation. Fullness was related to distal gastric volume in both GERD patients and healthy controls (r= 0.761, p < 0.001 and r= 0.674, p= 0.001, respectively). In FD patients this relationship was not observed. Impaired proximal gastric volume change after ingestion of a nutrient drink is associated with a larger distal gastric volume and increased fullness. In health and in GERD patients, the distal stomach is important in the regulation of fullness. However, in FD patients with normal or altered gastric volume distribution, this relationship is disturbed, implying that other causes are involved in the excessive generation of fullness.