Rapid initial gastric emptying and hypersensitivity to gastric filling in functional dyspepsia: effects of duodenal lipids.
OBJECTIVE
Impaired distension-induced gastric accommodation and hypersensitivity to distension have been demonstrated by gastric barostat in patients with functional dyspepsia (FD). In this study we investigated distension-induced responses to gastric filling with water in healthy volunteers and FD patients, using non-invasive ultrasonography.


METHODS
Eighteen healthy volunteers and 18 FD patients were given infusions of 10 ml saline or lipid (3 kcal/ml) through a nasoduodenal tube. After tube retraction, the stomach was filled with 1000 ml water during 10 min. Intragastric volume was monitored by 3D ultrasonography, and fullness, pain and nausea were assessed.


RESULTS
Compared with healthy volunteers, patients with FD had faster gastric emptying at 5 min (p = 0.0008) and reported more fullness (p = 0.006) during gastric filling with water. Prior duodenal lipid exposure reduced initial gastric emptying rate in FD patients to the level seen in healthy volunteers. However, despite similar gastric volumes, the patients still reported greater fullness (p = 0.002) and nausea (p = 0.01).


CONCLUSIONS
Patients with FD had abnormally rapid initial gastric emptying of water and hypersensitivity to gastric filling. Though normalizing gastric emptying rate and volumes, duodenal lipid exposure did not improve hypersensitivity. Rapid initial gastric emptying of water might be a sign of impaired distension-induced gastric accommodation.
Lunding
Johan A
JA
Department of Gastroenterology, Institute of Medicine and National Centre of Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway. johan.lunding@med.uib.no
Tefera
Solomon
S
Gilja
Odd Helge
OH
Hausken
Trygve
T
Bayati
Alfred
A
Rydholm
Hans
H
Mattsson
Hillevi
H
Berstad
Arnold
A
D000328:Adult; D004386:Duodenum; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D008055:Lipids / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D014463:Ultrasonography
D008055:Lipids