| Abstract I Evaluation of Proximal Gastric Sensitivity andAccommodation in Functional Dyspepsia and Its SubtypesAims:To investigate proximal gastric sensitivity and accommodation in FD and its subtypes with barostat study and explore underlying influencing factors.Subjects and Methods:30FD patients (13males,17females, mean age42.5±11.2years,15PDS patients and15EPS patients) fulfilling Rome III criteria and30healthy subjects (HS,14males,16females, mean age37.2±9.3years) were recruited. All subjects were surveyed with regards to demographic characteristics and features of FD symptom spectrum, and then gastric barostat was applied to assess the proximal gastric function. Minimal distending pressure (MDP), pressure and volume of thresholds for first-sensation and maximal tolerance for gastric sensitivity to intragastric bag distension were recorded. For gastric accommodation, the bag pressure level was set MDP+2mmHg, preprandial average volume during30min, postprandial average gastric volume, maximal accommodation volume and meal-induced volume were recorded.Results:(1) It was found that MDP (6.17±1.95mmHg vs9.27±1.99mmHg, P＜0.01), pressure of threshold for first-sensation (8.44±2.01mmHg vs12.04±2.6mmHg, P＜0.01) and maximal tolerance (14.62±3.72mmHg vs19.74±4.18mmHg, P＜0.01), volume of threshold for first-sensation (123.59±53.26mL vs168.41±73.06mL, P=0.009) and maximal tolerance (451.26±140.44mL vs556.89±124.07mL, P=0.004)were significantly lower in FD patients than that in HS.(2) There were no significant difference in MDP (6.39±2.27mmHg vs5.94±1.64mmHg), pressure of threshold for first-sensation (8.21±2.29mmHg vs8.67±1.74mmHg) and maximal tolerance (14.00±4.35mmHg vs15.24±2.99mmHg), volume of threshold for first-sensation (116.88±44.4mL vs130.29±61.67mL) and maximal tolerance (414.76±151.45mL vs487.77±122.74mL) between PDS patients and EPS patients.(3) The preprandial average volume during30min and postprandial average gastric volume calculated over60min showed no significant difference between FD patients and HS (212.19±120.82mL vs 191.69±66.19mL, P=0.418;333.97±121.86mL vs385.58±83.05mL, P=0.055). Maximal accommodation volume and meal-induced volume were also significantly lower in FD patients than that in HS (405.10±111.29mL vs461.10±87.60mL, P=0.031;190.16±97.22mL vs262.83±78.39mL, P=0.002).(4) Time to reach maximal volume in HS and FD patients were10-15min,15-20min respectively.(5) As to the range of normal value from HS, the proportion of gastric hypersensitivity accounted for43.7%in thirty FD patients, including six PDS patients, seven EPS patients. Impaired accommodation accounted for30%in thirty FD patients, including five PDS patients, four EPS patients. The proportion of gastric hypersensitivity and impaired accommodation showed no significant difference between PDS and EPS patients.(6) Early satiety and total dyspepsia symptom score were significantly related to the volume of maximal tolerance (r=-0.476, P=0.008; r=-0.513, P=0.004). There was significant difference on the volume for maximal tolerance between early-satiety and non-early satiety subgroups (372.42±123.86mL vs505.05±125.54mL, P=0.009).Conclusions:The proportion of gastric hypersensitivity and impaired accommodation were43.7%and30%in FD patients. There was no significant difference between PDS and EPS patients. FD and its subtypes fulfilling Rome III criteria cannot be distinguished efficiently according to the pathogenesis of the proximal stomach, further study is needed.Abstract II Evaluation of Gastric Sensitivity and Accommodation by Simultaneous Determination of Intragastric Pressure in Perfusion Nutrient Load TestAims:To investigate proximal gastric sensitivity and accommodation in FD and its subtypes by simultaneous determination of intragastric pressure in perfusion nutrient load test and explore underlying influencing factors.Subjects and Methods:57FD patients (21males,36females, mean age42.1±11.2years,27PDS patients,21EPS patients,9PDS with EPSpatients), and30HS (14males,16females, mean age37.2±9.3years) were recruited. All subjects were surveyed with regards to demographic characteristics and features of FD symptom spectrum, and then simultaneous determination of intragastric pressure in perfusion nutrient load test was conducted. Finally all the data were collected and analyzed.Results:(1) No statistical difference was found in intragastric pressure (IGP) and perfusion volume (PV) divided by gender, age and body mass index (P>0.05).(2) A marked decrease in intragastric pressure (IGP) and perfusion volume (PV) at maximal satiety was in FD group compared to HS (3.2±1.0mmHg vs4.9±1.2mmHg,541±267mL vs768±243mL, both P＜0.01).(3) IGP at maximal satiety was lower in PDS group (3.3±1.0mmHg), EPS group (3.3±1.0mmHg), PDS+EPS group (2.6±1.1mmHg) than in HS (4.9±1.2mmHg)(all P＜0.01). PV at maximal satiety was lower in PDS group (514±280mL) and PDS+EPS group (363±151mL) than HS (768±243mL)(all P<0.01). However, PV at maximal satiety was also lower in PDS+EPS group than in EPS group (363±151mL vs652±245mL, P=0.005).(4) Gastric compliance was no significant difference among FD and its subtypes or HS (P>0.05).(5) No significant difference was found in gastric sensitivity, accommodation or compliance between PDS and EPS patients.(6) According to the range of normal value from HS, the proportion of gastric hypersensitivity accounted for59.6%, including thirteen PDS patients, thirteen EPS patients and eight PDS+EPS patients, impaired accommodation for31.6%including nine PDS patients, four EPS patients and five PDS+EPS patients and both exist account for24.6%, including eight PDS patients, one EPS patients and five PDS+EPS patients.(7) When compared all these parameter in symptoms based subgroups and HS, we can find that except EPS-epigastric pain group, IGP and perfusion volume (PV) at maximal satiety were lower in PDS-postprandial distention, PDS-postprandial distention with early satiety and PDS+EPS group than HS (P<0.05). There was significant difference in PV at minimal and maximal satiety between early-satiety and non-early satiety subgroups (72±41mL vs118±85mL,400±184mL vs598±274mL, P=0.033,0.008). There were significant difference in postprandial distention, early satiety and TDSS between FD patients with normal and impaired accommodation (P=0.030,0.017,0.039). Conclusions:Simultaneous determination of intragastric pressure in perfusion nutrient load test could be useful for evaluating proximal stomach function in FD patients. Early satiety was closely associated with gastric impaired accommodation.Abstract Ⅲ Evaluation of Gastric Sensitivity and Accommodation by Simultaneous Determination of Intragastric Pressure in Perfusion Nutrient Load Test-Compared with the Barostat Study Aims:To extensively evaluate the method of simultaneous determination of intragastric pressure (IGP) in perfusion nutrient load test (PNLT) in HS and FD patients compared with the barostat study.Subjects and Methods:30HS and30FD patients were recruited. All HS and FD patients were received simultaneous determination of IGP in PNLT. The barostat study was completed in another day. Visual analogue scale (VAS) was used to evaluate satiety during simultaneous determination of IGP in PNLT and the barostat study. Gastric accommodation was conducted after gastric sensitivity to intragastric bag distension. Finally, all totally data were collected and analyzed.Results:(1) No statistical difference was found the results with simultaneous determination of IGP in PNLT and the barostat study divided by gender, age and body mass index.(2) In HS, pressure of different satiety evaluated by VAS have significant correlation between the two methods (score1-2:r=0.441, P=0.015; score3-4:r=0.527, P=0.003; score5-6:r=0.405, P=0.026; score7-8:r=0.402, P=0.028; score9-10:r=0.406, P=0.006). Volume of different satiety evaluated by VAS also had significant correlation between the two methods (score1-2:r=0.498, P=0.005; score3-4:r=0.481, P=0.007; score5-6:r=0.362, P=0.049; score7-8:r=0.449, P=0.013; score9-10:r=0.453, P=0.012). Maximal perfusion volume has significant correlation compared to postprandial average gastric volume calculated over60min (r=0.424, P=0.020); IGP at maximal satiety was significant correlation compared to maximal accommodation volume after drinking and meal induced relaxation volume (r=0.454, P=0.012; r=0.402, P=0.028). In FD and PDS, volume of different satiety evaluated by VAS had significant correlation between the two methods respectively (FD:r=0.380,0.382,0.557,0.590,0.626, P=0.038,0.037,0.001,0.001,0.001; PDS:r=0.691,0.606,0.705,0.700,0.717, P=0.004,0.017,0.003,0.004,0.003). However, only perfusion volume at maximal satiety in EPS was significant correlated with that of the barostat study (r=0.579, P=0.024). In FD and its subtypes PDS and EPS, maximal perfusion volume was significantly correlated with gastric postprandial average volume and maximal accommodation volume by the barostat study (FD:r=0.453, P=0.022; r=0.569, P=0.001; PDS:r=0.589, P=0.021; r=0.595, P=0.019; EPS:r=0.520, P=0.047; r=0.542, P=0.037).Conclusions:The method of simultaneous determination of IGP in PNLT has a good correlation with the barostat study, excellent feasibility, safety and could be useful for evaluating proximal stomach function. AbstractIV Symptoms Characteristics and Possible Relative Factors in Patients with Functional Dyspepsia and its SubtypesAims:To investigate the difference between FD patients and different subtypes at the aspects of demographics, dyspeptic symptomology, HP infection, caused and aggravating factors, social support, ill behavior, psychological condition and so on.Subjects and Methods:96FD patients (34males,62females, mean age,42.9±11.6years) surveyed with Rome III modular questionnaire were divided into three groups: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and PDS mixed with EPS. The data including demographics, dyspeptic symptomology, HP infection, caused and aggravating factors, social support, illness behavior, and psychological condition were recorded. The entire index was compared among different subtype of FD patients.Results:(1) The proportions of the patients were42.7%of PDS patients,32.3%of EPS patients and25.0%of PDS with EPS patients.(2) Diet, angry, overwork, work pressure and stress to induce functional dyspepsia symptoms were not significant differences among PDS, EPS and PDS+EPS group. In aggravating factors, diet was significant difference between PDS and EPS (34.1%vs71.0%, P=0.032).(3) HP infection rate in FD patients and its subtypes were22.5%,24.3%,19.2%and23.5%. There were no significant difference among the three subtypes in HP infection rate (P>0.05).(4) There was no significant difference in social support among PDS, EPS, PES+EPS patients or HS.(5) Nine and seven of illness behavioral indicators were higher in FD patients and its subtypes.(6) No significant difference were found in psychological status (P>0.05). However, score of early satiety was significantly higher in SDS normal group than in SDS abnormal group (P=0.019).Conclusions:There was no significant difference in demographics, dyspeptic symptomology, related diet, caused and aggravating factors, social support, illness behavior, psychological condition among PDS, EPS or PDS+EPS. Dietary factor play a role in exacerbating symptoms in EPS patients. Depression state was more likely happened in FD patients with early satiety. |
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