Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Gastroenterology. 2013 Sep;145(3):566-73. doi: 10.1053/j.gastro.2013.05.018. Epub 2013 May 20.
BACKGROUND & AIMS: Hypersensitivity to gastric distention, an important feature of functional dyspepsia, is assessed by stepwise balloon distention of the proximal stomach in fasting patients. However, symptoms of functional dyspepsia are often worse after a meal, so studies of postprandial balloon distentions might be more relevant. We compared the effects of fasting and postprandial stomach distention in patients with functional dyspepsia.
Twenty healthy controls and 62 patients with functional dyspepsia participated in a gastric barostat study at Leuven University Hospital with graded isobaric distentions before and after a liquid meal. On a separate day, all patients underwent a gastric emptying breath test with assessment of postprandial severity of 6 different dyspeptic symptoms scored at 15-minute intervals for 4 hours. For each symptom, a meal-related severity score was obtained by adding all scores; the cumulative symptom score (CSS) was obtained by adding individual symptom severity scores.
In patients, but not in controls, postprandial sensitivity to balloon distention was significantly greater than fasting sensitivity. The CSS and individual symptom scores did not differ between patients with normal or hypersensitivity to fasting distention, but patients who were hypersensitive to postprandial distention had a significantly higher CSS, along with scores for postprandial fullness, bloating, and nausea (all P < .05). On multivariate analysis, hypersensitivity to postprandial distention was associated with hypersensitivity to fasting distention and with impaired accommodation to a meal.
Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia.
对胃扩张的高度敏感是功能性消化不良的一个重要特征，通过对空腹患者近端胃进行逐步球囊扩张来评估。然而，功能性消化不良的症状通常在餐后更严重，因此餐后球囊扩张的研究可能更相关。我们比较了空腹和餐后胃扩张对功能性消化不良患者的影响。
20 名健康对照者和 62 名功能性消化不良患者在鲁汶大学医院参加了胃测压研究，在空腹和餐后液体餐后进行了分级等压扩张。在另一天，所有患者都进行了胃排空呼吸试验，并在 4 小时内每 15 分钟评估 6 种不同消化不良症状的餐后严重程度评分。对于每种症状，通过添加所有评分获得与进餐相关的严重程度评分；通过添加个体症状严重程度评分获得累积症状评分（CSS）。
在患者中，但不在对照组中，餐后球囊扩张的敏感性明显大于空腹敏感性。CSS 和个体症状评分在对空腹扩张敏感或不敏感的患者之间没有差异，但对餐后扩张敏感的患者 CSS 明显更高，伴有餐后饱胀、腹胀和恶心评分（均 P <.05）。在多变量分析中，对餐后扩张的高度敏感与对空腹扩张的高度敏感以及对进餐的适应不良有关。
餐后而不是空腹扩张阈值与功能性消化不良患者与进餐相关症状的严重程度有关。
