Original article—alimentary tract
Relationship Between Symptoms and Dietary Patterns in Patients With Functional Dyspepsia

https://doi.org/10.1016/j.cgh.2008.09.007Get rights and content

Background & Aims

Patients with functional dyspepsia (FD) often report that their symptoms are related to food ingestion. However, there is a lack of information about differences in eating patterns and nutrient intake between these patients and healthy individuals or the association with specific symptoms. We performed a prospective trial to evaluate the relationship between FD symptoms and dietary factors.

Methods

Twenty patients with FD (17 women) and 21 healthy subjects (18 women) completed detailed diet diaries, recording all foods eaten, drinks consumed, and times of consumption, as well as the occurrence, timing, and severity of dyspeptic symptoms (ie, nausea, discomfort, fullness, bloating, upper-abdominal/epigastric pain) for 7 days. Data from the diet diaries were analyzed for the number of meals, light meals, snacks and drinks, energy intake, and macronutrient distribution.

Results

Patients with FD ate fewer meals (P < .01) and consumed less total energy (P = .1) and fat (P = .1) than healthy subjects. Their symptoms were modest in severity (score out of 10; 5 [range, 3–8]) and occurred within 31 minutes (range, 8–64 min) of eating. Fullness was related directly to the amount of fat ingested (z, 1.91; P < .05) and overall energy intake (z, 2.12; P < .05) and related inversely to the amount of carbohydrate ingested (z, −1.9; P = .05). Similarly, bloating was related to the amount of fat ingested (z, 1.68; P = .09). There was no significant relationship between symptom severity and any of the dietary variables measured.

Conclusions

Management of patients with FD might be improved by instructing them to consume smaller meals with reduced fat content.

Section snippets

Subjects

Twenty FD patients (17 women, 3 men; age, 45 ± 3 y; range, 23–73 y; body mass index [BMI], 24.0 ± 0.9 kg/m2; range, 19.3–35.7 kg/m2) were recruited through advertisements in a local newspaper (n = 3) and from the endoscopy list and outpatients of the Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital (n = 17). The patients had to have experienced postprandial fullness, bloating, epigastric pain, nausea, or vomiting for more than 3 months of at least a moderate

Eating Behavior

The number of meals was less in FD patients when compared with healthy subjects (P < .01), and in healthy subjects reflected average Australian eating habits of one main meal per day. There were no other significant differences (Table 1). There was also no difference in the total weight, carbohydrate, protein, or alcohol content of foods consumed, or the percentage of macronutrient distribution, although fat and energy intake tended to be less in the patients (P = .1) (Table 2), the time

Discussion

We formally evaluated eating behavior in FD patients and healthy subjects and the relationships between symptoms with food intake. The major findings in FD patients are as follows: (1) symptoms are related to food intake, specifically, fullness with both fat and energy intake and bloating with fat intake; (2) the number of full meals consumed is less, with no differences in the number of other eating episodes, or the weight or macronutrient content consumed; (3) fat and energy intake tended to

Acknowledgements

The authors thank Ms Nancy Briggs for her assistance with the statistical analysis.

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    Conflicts of interest The authors disclose the following: Amelia Pilichiewicz was supported by a Dawes Postgraduate Scholarship provided by the Royal Adelaide Hospital and Christine Feinle-Bisset was supported by a National Health and Medical Research Council of Australia Career Development Award. The study was supported by National Health and Medical Research Council of Australia project grant 242802 (2003−2005) and a Royal Adelaide Hospital Research Committee Project Grant in 2002.

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