title: Vagal activation by sham feeding improves gastric motility in functional dyspepsia.
abstract: Antral hypomotility and impaired gastric accommodation in patients with functional dyspepsia have been ascribed to vagal dysfunction. We investigated whether vagal stimulation by sham feeding would improve meal-induced gastric motor function in these patients. Fourteen healthy volunteers and 14 functional dyspepsia patients underwent a drink test twice, once with and once without simultaneous sham feeding. After ingesting 500 mL clear meat soup (20 kcal, 37 degrees C) in 4 min, sham feeding was performed for 10 min by chewing a sugar-containing chewing gum while spitting out saliva. Using two- and three-dimensional ultrasound, antral motility index (contraction amplitude x frequency) and intragastric volumes were estimated. Without sham feeding, functional dyspepsia patients had lower motility index than healthy volunteers (area under curve 8.0 +/- 1.2 vs 4.4 +/- 1.0 min(-1), P = 0.04). In functional dyspepsia patients, but not in healthy volunteers, motility index increased and intragastric volume tended to increase by sham feeding (P = 0.04 and P = 0.06 respectively). The change in motility index was negatively correlated to the change in pain score (r = -0.59, P = 0.007). In functional dyspepsia patients, vagal stimulation by sham feeding improves antral motility in response to a soup meal. The result supports the view that impaired vagal stimulation is implicated in the pathogenesis of gastric motility disturbances in functional dyspepsia.
authors.affiliation: Section for Gastroenterology, Institute of Medicine, University of Bergen, Bergen, Norway. johan.lunding@med.uib.no
authors.forename: J A
authors.initials: JA
authors.lastname: Lunding
authors.forename: L M
authors.initials: LM
authors.lastname: Nordström
authors.forename: A-O
authors.initials: AO
authors.lastname: Haukelid
authors.forename: O H
authors.initials: OH
authors.lastname: Gilja
authors.forename: A
authors.initials: A
authors.lastname: Berstad
authors.forename: T
authors.initials: T
authors.lastname: Hausken
mesh_terms: D000328:Adult; D004415:Dyspepsia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D004435:Eating / Q000502:physiology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D008297:Male; D010919:Placebos / Q000627:therapeutic use; D014630:Vagus Nerve / Q000502:physiology*
chemical_list: D010919:Placebos