Impaired drinking capacity in patients with functional dyspepsia: Relationship with proximal stomach function

doi:10.1053/gast.2001.28656

Gastroenterology

Volume 121, Issue 5, November 2001, Pages 1054-1063

https://doi.org/10.1053/gast.2001.28656 Get rights and content

Abstract

Background & Aims: Impaired fundic accommodation to a meal and hypersensitivity to distention are increasingly recognized as important mechanisms underlying functional dyspepsia (FD). In the present study, we evaluated whether a drink test can predict such abnormalities and thus represent a noninvasive tool to study proximal stomach motor function. Methods: Healthy volunteers (HV), nonconsulters with mild dyspeptic symptoms (MS), and patients with FD filled out a disease-specific questionnaire and underwent a drink test with either water or with a high calorie fluid. The maximal ingested volume and the subsequent symptoms were meticulously recorded. In addition, all subjects underwent a gastric barostat study assessing meal-induced relaxation and sensation to distention. Results: Drinking capacity was not significantly related to any particular dyspeptic symptom. FD were able to consume less water (893 ± 70 mL) and caloric liquid (767 ± 50 mL) compared with HV (water, 1764 ± 120 mL; caloric liquid, 1308 ± 96 mL) or MS (water, 1645 ± 120 mL; caloric liquid, 973 ± 45 mL). Approximately half of the FD had an abnormal water or Nutridrink test compared with 9% of MS and 4% of HV. Furthermore, FD developed significantly more symptoms than MS or HV after both drink tests. The drinking capacity did not predict impaired fundic accommodation or visceral hypersensitivity. Conclusions: FD, but not MS, have an impaired drinking capacity to both water and a nutrient liquid. The drinking capacity is not related to a specific dyspeptic symptom and does not predict proximal stomach motor function.

GASTROENTEROLOGY 2001;121:1054-1063

Section snippets

Subjects

Subjects without any abdominal complaints or with very mild dyspeptic symptoms who did not consult a physician, and with no previous abdominal surgery and taking no medications, were asked to participate in the study. In addition, patients from the outpatient clinic or patients referred to the endoscopy unit for upper endoscopy were included if they fulfilled the new Rome criteria of FD¹³ and if endoscopy was negative, i.e., no organic abnormality possibly explaining the dyspeptic complaints

Subjects and symptoms

To determine normal values, 44 healthy volunteers with an NDI score ≤ 5 (HV, 24 women and 19 men; age, 20-54 years) were invited to participate in study 1 and underwent both the water and the Nutridrink test.

Seventy-eight subjects agreed to participate in study 2. Nine subjects were included after exclusion of increased acid exposure. At 24 hours of pHmetry, pH was <4 in 1.9% ± 0.7% of time. Based on the NDI score, 25 HV (14 women and 11 men; age, 20-46 years), 11 subjects with mild symptoms (8

Discussion

In the present study, we showed that approximately half of the patients with FD have an impaired drinking capacity both for water and for a caloric liquid. In addition, the symptoms after the drink tests were more intense and lasted longer in FD compared with healthy volunteers and subjects with mild dyspeptic symptoms. The drinking capacity was not related to any particular dyspeptic symptom. Furthermore, no relationship was found between the drinking capacity and impaired fundic accommodation

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^☆: Address requests for reprints to: G. E. Boeckxstaens, Department of Gastroenterology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. e-mail: [email protected]; fax: (31) 20-691-70-33.

^☆☆: Sponsored by a grant from Janssen Research Foundation, Beerse, Belgium (to B.D.J.V.).

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Clinical ResearchImpaired drinking capacity in patients with functional dyspepsia: Relationship with proximal stomach function☆,☆☆

Abstract

Section snippets

Subjects

Subjects and symptoms

Discussion

Gastroenterology

Gastroenterology

Am J Gastroenterol

Gastroenterology

Gastroenterology

Gastroenterology

Am J Clin Nutr

Gastric accommodation in non-ulcer dyspepsia and the roles of Helicobacter pylori infection and vagal function

Gut

Responses to gastric distension in functional dyspepsia

Gut

Impaired accommodation of proximal stomach to a meal in functional dyspepsia

Dig Dis Sci

Abnormal intragastric distribution of food during gastric emptying in functional dyspepsia patients

Gut

Symptoms and visceral perception in severe functional and organic dyspepsia

Gut

Gastric hypersensitivity in nonulcer dyspepsia: an inconsistent finding

Dig Dis Sci

Clinical Research
Impaired drinking capacity in patients with functional dyspepsia: Relationship with proximal stomach function☆,☆☆