Abstract
Sensory and pressure responses to gastric distension were evaluated in 24 consecutive patients suffering from chronic idiopathic dyspepsia and 20 healthy subjects. A latex balloon was placed in the proximal stomach and inflated by increments of 100 ml of air up to a maximal volume of 800 ml. Symptom response and intragastric pressure-volume curve were recorded during the gradual balloon distension. Thirteen of the 24 patients experienced pain at a distension volume ≤400 ml of air, but only one of the 20 controls (P<0.001). Intragastric pressure-volume curves were similar in patients and controls, and in patients with and without abnormal pain threshold, suggesting that a compliance defect was not the cause of the sensory anomaly. Gastric emptying of solids and liquids was measured in 20 of the 24 patients using a dual isotopic technique; psychological status was also evaluated in 18 patients using the Mini-Mult test. The frequency of the sensory anomaly was not different in patients with (7/14) or without (4/6) gastric stasis, but was lower in patients with (5/13) than in those without psychological disturbances (5/5,P<0.01). Thus, a primary visceral sensory anomaly, either alone or in conjunction with motility disturbances, can play an important role in chronic idiopathic dyspepsia and must be taken in account for further therapeutic research.
Similar content being viewed by others
References
Adami HO, Agenas I, Gustavsson S: The clinical diagnosis of “gastritis.” Aspects of demographic epidemiology and health care consumption based on a nationwide sample survey. Scand J Gastroenterol 19:216–219, 1984
Jian R, Ducrot F, Piedeloup C, Mary JY, Najean Y, Bernier JJ: Measurement of gastric emptying in dyspeptic patients: Effect of a new gastrokinetic agent (cisapride). Gut 26:352–358, 1985
Malagelada JR, Stanghellini V: Manometric evaluation of functional upper gut symptoms. Gastroenterology 88:1223–1231, 1985
Jian R, Ducrot F, Ruskone A, Chaussade S, Rambaud JC, Modigliani R, Rain JD, Bernier JJ: Symptomatic, radionuclide and therapeutic assessment of chronic idiopathic dyspepsia: A double-blind placebo-controlled evaluation of cisapride. Dig Disease Sci 34:657–664, 1989
Kincannon JC: Prediction of the standard MMPI scale scores from 71 items: The Mini-Mult. J Consult Psychol 32:319–325, 1968
Stadaas JO: Intragastric pressure/volume relationship before and after proximal gastric vagotomy. Scand J Gastroenterol 10:129–134, 1975
Stadaas JO: Intragastric pressure/volume relationship in the normal human stomach. Scand J Gastroenterol 10:135–140, 1975
Richter JE, Barish CF, Castell DO: Abnormal sensory perception in patients with esophageal chest pain. Gastroenterology 91:845–852, 1986
Meyer JH: Motility of the stomach and gastroduodenal junction.In Physiology of the Gastrointestinal Tract, 2nd ed. LR Johnson (ed). New York, Raven Press, 1987, pp 613–629
Mearin F, Cucala M, Azpiroz F, Malagelada JR: Origin of gastric symptoms in functional dyspepsia. Gastroenterology 96:A337, 1989 (abstract)
Cook IJ, Van Eeden A, Collins SM: Patients with irritable bowel syndrome have greater pain tolerance than normal subjects. Gastroenterology 93:727–733, 1987
Edwards DAW: “Tender oesophagus”: A new syndrome. Gut 23:919, 1982 (abstract)
Ritchie J: Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 14:125–132, 1973
Swarbrick ET, Bat L, Hegarty JE, Williams CB, Dawson AM: Site of pain from the irritable bowel. Lancet 2:443–446, 1980
Stokes MA, Moriarty KJ, Catchpole BN: A study of the genesis of colic. Lancet 1:211–214, 1988
Melzack R, Wall PJ: The Challenge of Pain. New York, Basic Books, 1983
Talley NJ, Fung LH, Gilligan IJ, McNeil D, Piper DW: Association of anxiety, neuroticism and depression with dyspepsia of unknown cause. Gastroenterology 90:886–892, 1986
Di Mario F, Bernasconi G, Mastropaolo G, Naccarato R: Psychological distress in dyspepsia of unknown cause. Dig Disease Sci 33:1052–1053, 1988
Cervero F: Neurophysiology of gastrointestinal pain. Clin Gastroenterol 2:183–199, 1988
Vantrappen G, Janssens J, Ghillebert G: The irritable oesophagus—a frequent cause of angina-like pain. Lancet 1:1232–1234, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lémann, M., Dederding, J.P., Flourie, B. et al. Abnormal perception of visceral pain in response to gastric distension in chronic idiopathic dyspepsia. Digest Dis Sci 36, 1249–1254 (1991). https://doi.org/10.1007/BF01307517
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01307517