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Association between duodenal bile salts and gastric emptying in patients with functional dyspepsia
  1. Lucas Wauters1,2,
  2. Matthias Ceulemans2,
  3. Maarten Lambaerts2,
  4. Alison Accarie2,
  5. Joran Toth2,
  6. Raf Mols3,
  7. Patrick Augustijns3,
  8. Jan Tack1,2,
  9. Tim Vanuytsel1,2
  1. 1Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
  2. 2Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases Metabolism and Ageing (ChroMetA), KU Leuven, Leuven, Belgium
  3. 3Drug Delivery and Disposition, KU Leuven, Leuven, Flanders, Belgium
  1. Correspondence to Dr Tim Vanuytsel, Gastroenterology and Hepatology, KU Leuven University Hospitals Leuven, Leuven 3000, Belgium; tim.vanuytsel{at}med.kuleuven.be

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We read with interest the study by Higuchi et al, which identified mechanisms of increased satiation in Cyp8b1−/− mice via slowed gastric empting.1 Following data showing that deleting Cyp8b1, which is required to produce 12α-hydroxylated bile acids, impaired intestinal lipid absorption in mice, the authors convincingly demonstrated that lowering 12α-hydroxylated bile acids slowed gastric emptying in Cyp8b1−/− mice.1 Duodenal lipid infusion affects gastric function, and duodenal hypersensitivity to lipids has been studied in GI disorders with gastric dysmotility, such as functional dyspepsia (FD).2 FD is defined by upper GI symptoms originating from the gastroduodenal region with no structural disease on routine investigation.3 Although studies showed that lipids are a major trigger of dyspeptic symptoms, the effect was only partially explained by duodenal release of cholecystokinin.4 Interestingly, the release of bile salts has been linked to the generation of dyspeptic symptoms, possibly via duodenal luminal or mucosal changes including hyperpermeability.5 6 However, duodenal alterations have not …

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Footnotes

  • Contributors LW: study concept and design, data collection, analysis and interpretation of data, drafting of the manuscript and statistical analysis. MC: data collection, analysis and interpretation of data, and revision of the manuscript. ML, AA, JT and RM: data collection and revision of the manuscript. PA and JT: study concept and design, and revision of the manuscript. TV: study concept and design, analysis and interpretation of data, revision of the manuscript and study supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval All patients underwent upper GI endoscopy with duodenal biopsies and fluid aspiration via a nasoduodenal tube after approval by the ethics committee of the University Hospitals Leuven (approval number S60953) and written informed consent before taking part in the study.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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