Pathophysiological classification of functional dyspepsia using a novel drinking-ultrasonography test.
BACKGROUND
Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD symptoms includes impaired fundic accommodation, delayed gastric emptying, and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients.


METHODS
Subjects were 60 successive FD patients according to the Rome III criteria. A drinking-ultrasonography test was performed after subjects had fasted. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. The normal range of cross-sectional area and VAS were set using average +/- standard deviations of 33 healthy volunteers. Cases outside the normal range were diagnosed with a motor or sensory disorder.


RESULTS
The drinking-ultrasonography test classified FD patients into four groups without adverse effect or trouble. The distribution of each group was 27% in the normal group, 15% in the impaired relaxation group, 10% in the delayed emptying group, and 48% in the visceral hypersensitivity group. There was no significant correlation between the pathophysiological classification and subtypes of FD defined by the Rome III criteria.


CONCLUSIONS
We developed a novel drinking-ultrasonography test that was effective in classifying FD patients according to pathophysiological features.
Kato
Mototsugu
M
Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido 060-8468 Japan. m-kato@med.hokudai.ac.jp
Nishida
Urara
U
Nishida
Mutsumi
M
Hata
Tamotsu
T
Asaka
Rumiko
R
Haneda
Masahira
M
Yamamoto
Keiko
K
Imai
Aki
A
Yoshida
Takeshi
T
Ono
Shouko
S
Shimizu
Yuichi
Y
Asaka
Masahiro
M
D004326:Drinking; D004415:Dyspepsia / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011984:Sensory Receptor Cells / Q000502:physiology; D013270:Stomach / Q000503:physiopathology; D014463:Ultrasonography; D014867:Water
D014867:Water