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Does delayed gastric emptying really cause symptoms in functional dyspepsia?
  1. M Camilleri
  1. Correspondence to:
    Professor M Camilleri
    Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA; camilleri.michael{at}mayo.edu

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When the glove does fit, you should not acquit

In this month’s issue of Gut, Talley and colleagues1 report an interesting study on the opportunistic use of a database, acquired during the baseline period of four multicentre therapeutic trials, to explore the associations between gastric emptying and symptoms in functional dyspepsia (see page 933). This was not a prospective study designed to specifically address the question posed in the title of this commentary. Before analysing the information from this study, it is opportune to review three concepts that reflect recent papers from the literature.

Firstly, combinations of symptoms are associated with abnormal gastric functions. In a scholarly review, Tack et al surmised that 40–50% of patients with dyspepsia had impaired gastric accommodation after meal ingestion, 34–66% had gastric hypersensitivity, and 23–59% had delayed gastric emptying.2 Moreover, delayed gastric emptying was associated with early satiety, nausea, vomiting and fullness; impaired gastric accommodation with early satiety and fullness, and with weight loss in two of four studies; and visceral hypersensitivity with pain, belching, and weight loss in one of four studies.2

Secondly, symptoms of dyspepsia occur in combination, and they have already been shown to be associated with delayed gastric emptying. …

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