Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J
Division of Gastroenterology, Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Gastroenterology. 2001 Sep;121(3):526-35. doi: 10.1053/gast.2001.27180.
BACKGROUND & AIMS: Hypersensitivity to gastric distention has been reported in functional dyspepsia, but its characteristics and relevance to symptoms remain unclear. The aim of this study was to define hypersensitivity to gastric distention and its association to specific symptoms in functional dyspepsia.
We used a gastric barostat to study sensitivity to gastric distention in 80 healthy subjects and in 160 functional dyspepsia patients. Demographic characteristics, gastric emptying, Helicobacter pylori status, gastric accommodation, and a dyspepsia symptom score were obtained from all patients and the relationship with visceral sensitivity was assessed using univariate and multivariate analysis.
The increase of intra-balloon pressure over intra-abdominal pressure needed to induce discomfort or pain is the most appropriate expression of sensitivity to gastric distention because it yields a meaningful lower range of normal and it is independent from age and body mass index. Hypersensitivity to gastric distention was found in 34% of the patients, who did not differ from the other patients in demographic and other pathophysiological characteristics. Hypersensitivity to distention was associated with a higher prevalence of postprandial pain, belching, and weight loss.
Hypersensitivity to gastric distention is present in a subset of functional dyspepsia patients. It is associated with symptoms of postprandial epigastric pain, belching, and weight loss.
功能性消化不良患者中已报道存在胃扩张超敏反应,但其特征及与症状的相关性仍不明确。本研究旨在明确功能性消化不良患者对胃扩张的超敏反应及其与特定症状的关联。
我们使用胃内压测定仪研究了80名健康受试者和160名功能性消化不良患者对胃扩张的敏感性。获取了所有患者的人口统计学特征、胃排空、幽门螺杆菌感染状况、胃容纳功能及消化不良症状评分,并采用单因素和多因素分析评估其与内脏敏感性的关系。
引起不适或疼痛所需的球囊内压相对于腹腔内压的升高是对胃扩张敏感性的最合适表达,因为它产生了有意义的较低正常范围,且与年龄和体重指数无关。34%的患者存在胃扩张超敏反应,这些患者在人口统计学和其他病理生理特征方面与其他患者无差异。扩张超敏反应与餐后疼痛、嗳气和体重减轻的较高发生率相关。
部分功能性消化不良患者存在胃扩张超敏反应。它与餐后上腹部疼痛、嗳气和体重减轻症状相关。