Real-time evaluation of dyspeptic symptoms and gastric motility induced by duodenal acidification using noninvasive transnasal endoscopy.
BACKGROUND
Although different pathophysiological mechanisms have been suggested to be involved in functional dyspepsia, a practical method to clarify them has not been established. The aim of this study was to evaluate dyspeptic symptoms and gastric motility induced by duodenal acidification using transnasal endoscopy.


METHODS
Fourteen healthy volunteers (mean age, 32 years) were enrolled. Transnasal endoscopy was performed on all fasting volunteers. Dyspeptic symptoms and antral contractions were evaluated before and after duodenal infusions of pure water (20 ml/min for 5 min) and acid (0.1 N HCl, 20 ml/min for 5 min). The severity of various symptoms was assessed by each subject using a 10-cm visual analog scale every 2 min. The maximum severity scale was calculated as the mean of the individual maximum values. The motility number was defined as the mean number of antral contractions in 1 min.


RESULTS
The maximum severity score for a heavy feeling in the stomach and other symptoms significantly increased after the acid infusion compared with after the pure water infusion. During pure water infusion, there were no changes in the motility number. On the other hand, the motility number significantly decreased after duodenal acidification (before vs. after, 2.93 +/- 0.12 times vs. 1.11 +/- 0.23 times, P < 0.0001).


CONCLUSIONS
Duodenal acid exposure induces dyspeptic symptoms and inhibits antral motility. Transnasal endoscopy enabled us to evaluate both dyspeptic symptoms and gastric motility simultaneously.
Ishii
Manabu
M
Department of Internal Medicine, Division of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan.
Manabe
Noriaki
N
Kusunoki
Hiroaki
H
Kamada
Tomoari
T
Sato
Motonori
M
Imamura
Hiroshi
H
Shiotani
Akiko
A
Hata
Jiro
J
Haruma
Ken
K
D000328:Adult; D004386:Duodenum / Q000473:pathology; D004415:Dyspepsia / Q000175:diagnosis*; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D006851:Hydrochloric Acid / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects; D009666:Nose; D011706:Pyloric Antrum / Q000378:metabolism; D012720:Severity of Illness Index; D016037:Single-Blind Method; D055815:Young Adult
D006851:Hydrochloric Acid