Hausken T, Gilja O H, Undeland K A, Berstad A
Division of Gastroenterology, Medical Dept. A, Haukeland University Hospital, Bergen, Norway.
Scand J Gastroenterol. 1998 Aug;33(8):822-7. doi: 10.1080/00365529850171477.
Patients with functional dyspepsia often experience early satiety and discomfort after a meal. The role of early gastric emptying in symptom generation is not known. Our aim was to relate timing of symptoms and early postprandial emptying in functional dyspepsia.
Twelve patients with functional dyspepsia were investigated during 3 min of fasting, during 3 min of ingesting 500 ml of a meat soup, and during the first 10 min postprandially by means of duplex sonography.
Gastric emptying commenced on average 52 sec after the start of ingestion. Transpyloric movements of gastric contents unrelated to peristalsis (that is, alternating transpyloric emptying and reflux within a common chamber created by the terminal antrum, the pylorus, and the duodenal bulb) appeared before peristaltic-related emptying, which commenced after on average 116 sec. In all patients epigastric, meal-related discomfort was experienced after the commencement of transpyloric emptying, on average after 143 sec. A negative correlation was found between intensity of fullness and duration of presymptomatic transpyloric movements of gastric contents (that is, the duodenal 'tasting' period).
The early occurrence of meal-related symptoms suggests that gastric distension is the main factor in symptom generation. However, the onset of symptoms after the commencement of gastric emptying suggests that intestinal tasting receptors are involved in symptom generation. The inverse relationship between the duration of the tasting period and symptom intensity suggests that the time allowed for duodenal tasting might be too short in patients with FD.
功能性消化不良患者常在餐后出现早饱及不适。胃排空过早在症状产生中的作用尚不清楚。我们的目的是探讨功能性消化不良患者症状出现的时间与餐后早期胃排空之间的关系。
对12例功能性消化不良患者在禁食3分钟、摄入500毫升肉汤3分钟以及餐后最初10分钟内进行双功超声检查。
摄入开始后平均52秒开始胃排空。胃内容物的跨幽门运动与蠕动无关（即由胃窦末端、幽门和十二指肠球部形成的共同腔内跨幽门排空和反流交替出现），出现在与蠕动相关的排空之前，后者平均在116秒后开始。在所有患者中，跨幽门排空开始后平均143秒出现上腹部与进餐相关的不适。饱腹感强度与症状前胃内容物跨幽门运动持续时间（即十二指肠“品尝”期）之间呈负相关。
与进餐相关症状的早期出现提示胃扩张是症状产生的主要因素。然而，胃排空开始后症状才出现提示肠道味觉感受器参与了症状的产生。品尝期持续时间与症状强度之间的负相关提示，功能性消化不良患者十二指肠品尝的时间可能过短。
