Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730, China.
Dig Dis Sci. 2013 Sep;58(9):2550-5. doi: 10.1007/s10620-012-2363-5. Epub 2012 Sep 4.
Functional dyspepsia-epigastric pain syndrome (FD-EPS) is characterized pathophysiologically by visceral hypersensitivity, but the effect of the temperature stimulation on gastric function has been seldom studied.
The purpose of this study was to investigate the effects of liquid nutrients at different temperatures on the gastric accommodation, sensitivity, and gastric-wall compliance of healthy subjects (HS) and FD-EPS patients.
Ten FD-EPS patients (Roma III criteria) and ten HS were recruited into the study. Intragastric pressure (IGP) and gastric perfusion were measured and compared following the administration of liquid nutrients at 37 °C on day 1 and at 8 °C on day 2.
Seven patients developed abdominal discomfort or abdominal pain after being given cold liquid nutrient. The administration of liquid nutrient at 8 °C resulted in an increase of IGP in HS (P=0.044), a significant decrease in gastric perfusion (P<0.0001), a marked increase in IGP (P=0.015), and a dramatic reduction in gastric wall compliance (P=0.012) in patients compared to the effects of liquid nutrient at 37 °C. In addition, IGP in patients was lower than that in HS at 37 °C liquid nutrient (P=0.036), and the gastric perfusion volume in patients at maximal satiety was also significantly reduced at 8 °C liquid nutrient compared with HS (P=0.017).
Cold stimulation can increase the IGP in HS and FD-EPS patients, elevate the visceral sensitivity and reduce the gastric volume of FD-EPS patients. FD-EPS patients who are sensitive to cold may develop epigastric discomfort or pain.
功能性消化不良-餐后不适综合征(FD-EPS)的病理生理学特征为内脏高敏性,但关于温度刺激对胃功能的影响研究较少。
本研究旨在探讨不同温度的液体营养物质对健康受试者(HS)和 FD-EPS 患者胃容纳、敏感性和胃壁顺应性的影响。
纳入 10 例 FD-EPS 患者(罗马 III 标准)和 10 例 HS。在第 1 天给予 37°C 的液体营养物质,第 2 天给予 8°C 的液体营养物质,测量并比较胃内压(IGP)和胃灌注。
7 例患者在给予冷液体营养物质后出现腹部不适或腹痛。与 37°C 液体营养物质相比,8°C 液体营养物质可引起 HS 的 IGP 增加(P=0.044)、胃灌注显著减少(P<0.0001)、IGP 明显增加(P=0.015)和胃壁顺应性显著降低(P=0.012);此外,与 HS 相比,患者在 37°C 液体营养物质时的 IGP 更低(P=0.036),且患者在最大饱腹感时的胃灌注量在 8°C 液体营养物质时也明显减少(P=0.017)。
冷刺激可增加 HS 和 FD-EPS 患者的 IGP,提高内脏敏感性,减少 FD-EPS 患者的胃容量。对冷敏感的 FD-EPS 患者可能会出现上腹部不适或疼痛。