Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
J Gastroenterol Hepatol. 2013 Nov;28(11):1699-704. doi: 10.1111/jgh.12309.
Stress is believed to play a role in the pathogenesis of functional gastrointestinal disorders. The aim of the present study was to investigate the effect of acute auditory stress on gastric motor responses to a meal in healthy subjects.
A total of eight healthy volunteers (seven men and one woman; median age, 33.4 years [30-35 years]) who had no recurrent gastrointestinal symptoms participated in the prospective, randomized, crossover study. Gastric half-emptying time and meal-induced proximal gastric accommodation were measured using gastric scintigraphy under the auditory stress and control conditions in a randomized crossover design.
The gastric half-emptying time under the stress condition was significantly longer than that under the control condition (130.8 ± 16.6 vs. 105.0 ± 13.1 min; P = 0.005 by paired t-test). Under the stress and control conditions, the proximal gastric volume significantly increased after a meal (P < 0.001 by repeated measures analysis of variance). The degree of the postprandial increase in proximal gastric volume did not significantly differ between both conditions (P = 0.598 by tests of between-subjects effects using repeated measures analysis of variance). The severity scores of postprandial epigastric discomfort and fullness were significantly higher under the stress condition than under the control condition (P = 0.001 and P = 0.039, respectively, by paired t-test).
Acute auditory stress delays gastric emptying and increases the severity of postprandial symptoms in the healthy subjects, suggesting the relevance of psychological stress to the pathophysiological mechanism of functional dyspepsia.
应激被认为在功能性胃肠疾病的发病机制中起作用。本研究旨在探讨急性听觉应激对健康受试者餐后胃动力反应的影响。
共有 8 名健康志愿者（7 名男性和 1 名女性；中位年龄 33.4 岁[30-35 岁]）参加了这项前瞻性、随机、交叉研究，他们没有反复发作的胃肠道症状。在随机交叉设计中，使用胃闪烁扫描法在听觉应激和对照条件下测量胃排空半时间和餐后近端胃顺应性。
应激条件下的胃排空半时间明显长于对照条件下的胃排空半时间（130.8±16.6 分钟与 105.0±13.1 分钟；配对 t 检验，P=0.005）。在应激和对照条件下，餐后近端胃容量明显增加（重复测量方差分析，P<0.001）。两种条件下餐后近端胃容量增加的程度无显著差异（重复测量方差分析的受试者间效应检验，P=0.598）。应激条件下餐后上腹部不适和饱胀的严重程度评分明显高于对照条件下（配对 t 检验，P=0.001 和 P=0.039）。
急性听觉应激延迟胃排空，并增加健康受试者餐后症状的严重程度，提示心理应激与功能性消化不良的病理生理机制有关。
