In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity

Ricard Farré, Hanne Vanheel, Tim Vanuytsel, Tatsuhiro Masaoka, Hans Törnblom, Magnus Simrén, Lukas Van Oudenhove, Jan F. Tack

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

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. Methods 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. Results 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. Conclusions Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia.

Original languageEnglish
Pages (from-to)566-573
Number of pages8
JournalGastroenterology
Volume145
Issue number3
DOIs
Publication statusPublished - 2013 Sep
Externally publishedYes

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Dyspepsia
Meals
Hypersensitivity
Fasting
Stomach
Breath Tests
Gastric Emptying
Nausea
Multivariate Analysis

Keywords

  • FD
  • Gastric Accommodation
  • Postprandial Distress Syndrome
  • Visceral Hypersensitivity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. / Farré, Ricard; Vanheel, Hanne; Vanuytsel, Tim; Masaoka, Tatsuhiro; Törnblom, Hans; Simrén, Magnus; Van Oudenhove, Lukas; Tack, Jan F.

In: Gastroenterology, Vol. 145, No. 3, 09.2013, p. 566-573.

Research output: Contribution to journalArticle

Farré, R, Vanheel, H, Vanuytsel, T, Masaoka, T, Törnblom, H, Simrén, M, Van Oudenhove, L & Tack, JF 2013, 'In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity', Gastroenterology, vol. 145, no. 3, pp. 566-573. https://doi.org/10.1053/j.gastro.2013.05.018
Farré, Ricard ; Vanheel, Hanne ; Vanuytsel, Tim ; Masaoka, Tatsuhiro ; Törnblom, Hans ; Simrén, Magnus ; Van Oudenhove, Lukas ; Tack, Jan F. / In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. In: Gastroenterology. 2013 ; Vol. 145, No. 3. pp. 566-573.
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AU - Masaoka, Tatsuhiro

AU - Törnblom, Hans

AU - Simrén, Magnus

AU - Van Oudenhove, Lukas

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AB - 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. Methods 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. Results 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. Conclusions Postprandial, but not fasting, distention thresholds are related to the severity of meal-related symptoms in patients with functional dyspepsia.

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