Lee Kwang Jae, Kim Jin Hong, Cho Sung Won
Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, South Korea.
J Gastroenterol Hepatol. 2006 Mar;21(3):515-20. doi: 10.1111/j.1440-1746.2005.03976.x.
Duodenal acidification might increase sensitivity to gastric distension, which seems to play a role in the genesis of dyspeptic symptoms in a subset of patients with functional dyspepsia. The aim of the present study was to investigate the characteristics of dyspeptic symptoms associated with hypersensitivity to gastric distension induced by duodenal acidification.
An infusion tube and a barostat bag were positioned in the duodenum and gastric fundus, respectively. Sensitivity to stepwise fundic distensions with severity scoring of the seven dyspeptic symptoms was assessed before and during duodenal acid infusion in 20 healthy subjects.
Acid infusion significantly decreased the pressures and the corresponding wall tensions at the thresholds for discomfort. At the distending level of minimal distending pressure (MDP) + 2 mmHg, significantly higher scores of fullness and bloating were obtained during acid infusion. With distending stimuli of MDP + 4 and 6 mmHg, fullness, bloating, nausea, satiety, epigastric burning and epigastric pain were significantly more severe during acid infusion than before acid infusion. At the level of MDP + 8 mmHg, the severity of epigastric pain was significantly greater, compared with that before acid infusion.
Duodenal acidification might aggravate dyspeptic symptoms through the induction of hypersensitivity to gastric distension in healthy individuals. Those symptoms are diverse and variable, depending on the strength of the distending stimuli.
十二指肠酸化可能会增加对胃扩张的敏感性，这似乎在一部分功能性消化不良患者消化不良症状的发生中起作用。本研究的目的是调查与十二指肠酸化诱导的胃扩张超敏反应相关的消化不良症状的特征。
分别在十二指肠和胃底放置一根输液管和一个恒压器袋。在20名健康受试者十二指肠酸灌注前和灌注期间，评估对逐步胃底扩张的敏感性以及七种消化不良症状的严重程度评分。
酸灌注显著降低了不适阈值时的压力和相应的壁张力。在最小扩张压力（MDP）+2 mmHg的扩张水平下，酸灌注期间饱胀感和腹胀评分显著更高。在MDP +4和6 mmHg的扩张刺激下，酸灌注期间的饱胀感、腹胀、恶心、饱腹感、上腹部烧灼感和上腹部疼痛比酸灌注前明显更严重。在MDP +8 mmHg水平下，与酸灌注前相比，上腹部疼痛的严重程度显著更高。
十二指肠酸化可能通过诱导健康个体对胃扩张的超敏反应而加重消化不良症状。这些症状多样且多变，取决于扩张刺激的强度。
