Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Aliment Pharmacol Ther. 2012 Jan;35(1):175-82. doi: 10.1111/j.1365-2036.2011.04918.x. Epub 2011 Nov 16.
The mechanisms of the development of symptoms in functional dyspepsia (FD) patients have not been fully elucidated. We previously reported that acid directly infused into the stomach causes dyspeptic symptoms in asymptomatic healthy controls (HCs); however, the response to acid infusion of FD patients was not determined.
To investigate the severity of dyspeptic symptoms induced by direct acid infusion in FD subjects and HCs.
This was a multi-centre, cross-over, randomised, double-blind study in 23 FD subjects and 32 HCs. FD was defined using the Rome III criteria. All subjects were Helicobacter pylori negative. Each subject received two tests; 0.1 mol/L hydrochloric acid and water infused into the stomach. The presence and severity of 12 dyspeptic symptoms were assessed using a visual analogue scale.
The proportion of subjects developing symptoms by acid or water infusion was significantly greater in FD subjects than HCs. All of the FD subjects experienced at least one symptom by water or acid infusion. In the FD subjects, the severity of symptoms was significantly greater with acid infusion than water infusion. The severity of symptoms in total and the scores for eight of the 12 symptoms induced by acid infusion was significantly greater in FD subjects than in HCs.
The severity of dyspeptic symptom generation induced by direct acid infusion into the stomach was significantly greater in functional dyspepsia subjects than in healthy controls, suggesting that hypersensitivity to acid is one of the important mechanisms of the development of symptoms in functional dyspepsia patients.
功能性消化不良（FD）患者症状的发展机制尚未完全阐明。我们之前报告过，直接将胃酸注入胃部会引起无症状健康对照者（HC）出现消化不良症状；然而，FD 患者对胃酸灌注的反应尚未确定。
研究直接胃酸灌注在 FD 患者和 HCs 中引起消化不良症状的严重程度。
这是一项多中心、交叉、随机、双盲研究，纳入了 23 名 FD 患者和 32 名 HCs。FD 采用 Rome III 标准定义。所有受试者均为幽门螺杆菌阴性。每位受试者接受两项测试；0.1mol/L 盐酸和水注入胃部。使用视觉模拟量表评估 12 种消化不良症状的存在和严重程度。
与 HCs 相比，FD 患者中通过胃酸或水灌注出现症状的受试者比例显著更高。所有 FD 患者均通过水或酸灌注出现至少一种症状。在 FD 患者中，与水灌注相比，胃酸灌注引起的症状严重程度显著更高。与 HCs 相比，FD 患者总症状严重程度以及 12 种症状中的 8 种症状因胃酸灌注而引起的评分均显著更高。
直接胃酸灌注引起的胃部消化不良症状严重程度在 FD 患者中明显高于健康对照者，提示酸敏感性增加是 FD 患者症状发生的重要机制之一。
