Papadopoulos Vasileios, Fragaki Maria, Mimidis Konstantinos
First Department of Internal Medicine, Democritus University of Thrace, Greece.
Arq Gastroenterol. 2009 Oct-Dec;46(4):304-10. doi: 10.1590/s0004-28032009000400011.
Drink tests constitute an inexpensive and non-invasive tool, which has been proposed to discriminate individuals with altered fluid intake, as dyspeptics. However, their use in everyday clinical practice is still limited as standardization still lacks.
To perform a direct, paired comparison between the water and the nutrient drink test in normal volunteers.
Thirty eight normal volunteers (19 males, 19 females, mean age 24.4 +/- 0.4 years) underwent drink test with water and nutrient (Nutridrink) within 7-10 days. Both tests included a loading (consumption of 100 mL/min for water and 15 mL/min for Nutridrink for the longest possible period of time) and a recuperation phase (observation after cessation of fluid intake), being separated by the maximal saturation point. During phases, satiety, fullness, discomfort, bloating, belching, nausea, pain and burning sensation (epigastric and thoracic) were recorded using a 0-100 visual analogue scale score (VAS). For the purpose of configuration, four variables were considered: time (t), VAS score (V), VAS slope (S) for a given time period, and probability of participation (Q) at a given timepoint.
The loading phase lasted for 11.6 +/- 1.7 min in water (total VAS: 879 +/- 123, total VAS slope 72.6 +/- 10.9 min-1) and 93.3 +/- 18.4 min in Nutridrink test (total VAS: 1462 +/- 411, total VAS slope 15.9 +/- 3.2 min-1); P<0.001. The mean ingested volume recorded was 1155 +/- 164 mL for water and 1399 +/- 276 mL for nutrient; P = 0.076. Cessation of fluid intake was mainly attributed to fullness (76.3%) in water and satiety (69.2%) in Nutridrink test. Nausea was recorded only in Nutridrink test (15.4%). No volunteer reported substantial, persistent pain or burning sensation. The recuperation phase lasted 63.6 +/- 7.8 min in water (total VAS: 278 +/- 75, total VAS slope 3.97 +/- 0.95 min-1) and 123.2 +/- 17.5 min in Nutridrink test (total VAS: 841 +/- 126, total VAS slope 6.81 +/- 1.63 min-1); P<0.001. Concerning total VAS scores for both phases of the two tests, fullness and satiety represented a mere four fifths of the total (43% and 36%, respectively). Belching (8%), bloating (6%), nausea (4%), and discomfort (3%) followed, while pain and burning sensation represented <1% of the whole. However, intra- and intertest correlations concerning total and symptom-specific VAS scores revealed statistically significant variations underlying differences in physiology of liquid intake. A multiple regression model considering body mass index, gender and age as dependent variables, and total and symptom-specific VAS scores and slopes for both phases of the two tests as independent variables, did not reveal any primary correlation. The function linking the expected probability of participation Q and symptom-specific VAS score V with time t is approached by the formulas Q(t)=1/[1+(t/c);k] and V(t)=V0*e;(-t/c), respectively; V0 is the mean symptom-specific VAS score, c, and k are phase- and test- related constants, and e = 2.718 is the base of natural logarithms.
The comparative standardization of both drink tests in normal individuals might provide a tool for clinical application, targeting the diagnosis and treatment of relevant functional disorders.
饮水测试是一种廉价且非侵入性的工具，已被提议用于鉴别液体摄入量改变的个体，如消化不良患者。然而，由于仍缺乏标准化，其在日常临床实践中的应用仍然有限。
对正常志愿者进行水和营养饮料测试的直接配对比较。
38名正常志愿者（19名男性，19名女性，平均年龄24.4±0.4岁）在7至10天内接受了水和营养饮料（营养饮品）测试。两项测试均包括负荷期（水以100毫升/分钟、营养饮品以15毫升/分钟的速度持续饮用尽可能长的时间）和恢复阶段（停止液体摄入后观察），两者由最大饱和度点分隔。在此期间，使用0至100的视觉模拟量表评分（VAS）记录饱腹感、饱胀感、不适感、腹胀、嗳气、恶心、疼痛和烧灼感（上腹部和胸部）。为了进行分析，考虑了四个变量：时间（t）、VAS评分（V）、给定时间段的VAS斜率（S）以及给定时间点的参与概率（Q）。
水的负荷期持续11.6±1.7分钟（总VAS：879±123，总VAS斜率72.6±10.9分钟⁻¹），营养饮品测试的负荷期持续93.3±18.4分钟（总VAS：1462±411，总VAS斜率15.9±3.2分钟⁻¹）；P<0.001。记录的平均摄入量水为1155±164毫升，营养饮品为1399±276毫升；P = 0.076。停止液体摄入主要归因于水测试中的饱胀感（76.3%）和营养饮品测试中的饱腹感（69.2%）。仅在营养饮品测试中记录到恶心（15.4%）。没有志愿者报告有严重、持续的疼痛或烧灼感。水的恢复阶段持续63.6±7.8分钟（总VAS：278±75，总VAS斜率3.97±0.95分钟⁻¹），营养饮品测试的恢复阶段持续123.2±17.5分钟（总VAS：841±126，总VAS斜率6.81±1.63分钟⁻¹）；P<0.001。关于两项测试两个阶段的总VAS评分，饱胀感和饱腹感仅占总数的五分之四（分别为43%和36%）。其次是嗳气（8%）、腹胀（6%）、恶心（4%）和不适感（3%），而疼痛和烧灼感占总体的不到1%。然而，关于总VAS评分和症状特异性VAS评分的测试内和测试间相关性揭示了液体摄入生理差异背后的统计学显著变化。一个多元回归模型将体重指数、性别和年龄作为因变量，将两项测试两个阶段的总VAS评分和症状特异性VAS评分及斜率作为自变量，未发现任何主要相关性。将预期参与概率Q和症状特异性VAS评分V与时间t联系起来的函数分别由公式Q(t)=1/[1+(t/c);k]和V(t)=V0*e;(-t/c)近似表示；V0是平均症状特异性VAS评分，c和k是与阶段和测试相关的常数，e = 2.718是自然对数的底数。
正常个体中两种饮品测试的比较标准化可能为临床应用提供一种工具，用于相关功能障碍的诊断和治疗。
