title: Duodenal hypersensitivity to acid in patients with functional dyspepsia-pathogenesis and evaluation.
abstract: Functional dyspepsia (FD) is a subcategory of the functional gastrointestinal disorders according to the Rome III classification of functional gastroduodenal disorders. FD is characterized by the presence of symptoms that are believed to be associated with gastroduodenal lesions, particularly epigastric pain or burning, postprandial fullness, or early satiation, without the evidence of organic disease likely to explain the onset of these symptoms. Generally, multiple factors are considered to be involved in the onset of dyspeptic symptoms in patients with FD. Among these factors, acid is thought to be more important because proton pump inhibitors (PPIs) and histamine 2 (H2)-receptor antagonists have been proposed to be effective therapies for a subset of patients with FD. Although manometric methods, scintigraphic methods, electrogastrography and ultrasonography have been used to evaluate enterokinesis, a practical method for evaluating duodenal hypersensitivity to acid has not been reported. Recently, we attempted to evaluate duodenal hypersensitivity to acid and gastric motility by duodenal acidification using transnasal endoscopy. Using this method, we could simultaneously evaluate both dyspeptic symptoms and gastric motility in healthy volunteers. Furthermore, we evaluated duodenal hypersensitivity to acid in healthy volunteers and in patients with FD, and we reported that duodenal acidification induced dyspeptic symptoms more significantly in patients with FD than in healthy volunteers.
authors.affiliation: Division of Gastroenterology Department of Internal Medicine, Kawasaki Medical School, Kawasaki Medical School, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ishii
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kusunoki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kamada
authors.forename: Motonori
authors.initials: M
authors.lastname: Sato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
mesh_terms: D004386:Duodenum / Q000503:physiopathology*; D004415:Dyspepsia / Q000150:complications / Q000503:physiopathology*; D005769:Gastrointestinal Motility; D006801:Humans; D006851:Hydrochloric Acid / Q000276:immunology*; D006967:Hypersensitivity / Q000209:etiology*
chemical_list: D006851:Hydrochloric Acid