Evaluation of duodenal hypersensitivity induced by duodenal acidification using transnasal endoscopy.
OBJECTIVE
Although duodenal hypersensitivity has been suggested as one of the causes of functional dyspepsia (FD), a practical method to clarify this has not yet been established. The aim of this study was to evaluate whether patients with FD have duodenal hypersensitivity to acid, using transnasal endoscopy.


METHODS
In all, 44 patients with FD and 16 healthy volunteers were enrolled, and all the subjects received transnasal endoscopy in the morning after overnight fasting. After ordinary transnasal endoscopy, an infusion tube was introduced into the duodenal bulb by transnasal endoscopy and acid (20 mL, 0.1 N HCl, 20 mL/min, 36.5 degrees C) was injected via the infusion tube. The severity of 12 symptoms was assessed by each subject using a 100-mm visual analogue scale. The maximum severity scale was defined as the maximum score of the symptom severity scale. The total score was defined as the aggregate score of the maximum severity scale of the 12 symptoms. The maximum severity scales and the total scores between patients with FD and healthy volunteers were evaluated.


RESULTS
The maximum severity scales of nine symptoms increased significantly more after acid infusion in patients with FD than in healthy volunteers (P < 0.05). There were significant differences in the total scores (patients with FD vs healthy volunteers 233.8 +/- 37.8 vs 63.9 +/- 14.6, mean +/- standard error of the mean, P < 0.001).


CONCLUSIONS
Duodenal acidification using transnasal endoscopy enabled the evaluation of duodenal hypersensitivity to acid in healthy volunteers and patients with FD.
Ishii
Manabu
M
Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan.
Kusunoki
Hiroaki
H
Manabe
Noriaki
N
Kamada
Tomoari
T
Sato
Motonori
M
Imamura
Hiroshi
H
Shiotani
Akiko
A
Hata
Jiro
J
Haruma
Ken
K
D000328:Adult; D016022:Case-Control Studies; D004386:Duodenum / Q000503:physiopathology*; D004415:Dyspepsia / Q000175:diagnosis* / Q000503:physiopathology; D004724:Endoscopy; D005260:Female; D006801:Humans; D006851:Hydrochloric Acid / Q000008:administration & dosage; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009666:Nose; D011237:Predictive Value of Tests; D012684:Sensory Thresholds; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors
D006851:Hydrochloric Acid