title: Postprandial symptoms originating from the stomach in functional dyspepsia.
abstract: BACKGROUND
  Functional dyspepsia (FD) is characterized by chronic epigastric symptoms. The stomach has been held responsible for the generation of symptoms, but the latest reports have pointed out that also the duodenum can be implicated in the pathophysiology. The aim of this study was to elucidate which dyspeptic symptoms originate from the stomach and/or from the small intestine after a meal.
  
  
  METHODS
  Two hundred eighty-four FD patients underwent a gastric emptying breath test. Breath samples were taken and the intensity of six dyspeptic symptoms (fullness, bloating, belching, nausea, epigastric burning, and epigastric pain) was scored before a meal and at 15 min intervals for a period of 240 min postprandially. Time curves of each symptom were analyzed and severity scores during the gastric and the intestinal phase were compared.
  
  
  RESULTS
  Time curves of fullness, bloating, belching, and nausea displayed a significant negative slope, while symptom severity of epigastric burning and epigastric pain did not decrease over time. Numerical analysis revealed that scores for fullness, bloating, and belching were higher during the gastric phase compared with the intestinal phase. On the other hand, intensities of nausea, epigastric burning, and epigastric pain were similar during both phases.
  
  
  CONCLUSIONS
  Intensities of fullness, bloating, and belching decrease with food moving from the stomach to the small intestine indicating that the stomach plays a crucial role in the generation of these symptoms. In contrast, the symptom severity of epigastric burning and epigastric pain persists with progression of food to the small intestine.
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Vanheel
authors.forename: T
authors.initials: T
authors.lastname: Vanuytsel
authors.forename: L
authors.initials: L
authors.lastname: Van Oudenhove
authors.forename: R
authors.initials: R
authors.lastname: Farré
authors.forename: K
authors.initials: K
authors.lastname: Verbeke
authors.forename: J
authors.initials: J
authors.lastname: Tack
mesh_terms: D000328:Adult; D001944:Breath Tests; D004386:Duodenum / Q000503:physiopathology*; D004415:Dyspepsia / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D013270:Stomach / Q000503:physiopathology*
keywords: breath test; epigastric pain syndrome; functional dyspepsia; gastric emptying; postprandial distress syndrome