Abstract :
Background: Impaired gastric accommodation has been reported in functional dyspepsia. Effects of
H. pylori eradication on proximal gastric functions in patients with functional dyspepsia have not been well ex-
plored.
Aim: To prospectively study the effects of H. pylori eradication on proximal gastric motor functions,
especially gastric accommodation, in patients with H. pylori associated functional dyspepsia.
Patients and Methods: Ten functional dyspepsia patients (5 male, 5 female, age 37 +/- 2.2 years, mean
+/- SEM) with H. pylori infection underwent a barostat study before and 3 months after H. pylori eradication. Barostat study was performed using an electronic barostat and a silicone manometric catheter incorporated with a 1,200 ml polyethylene bag. Compliance and perception of the proximal stomach were studied by 2-24 mmHg slow ramp distensions. Gastric perception such as nausea, fullness, and pain symptoms were scored during slow ramp distensions using a seven-point Likert scale (0-6). Gastric accommodation was evaluated by continuous distention of the proximal stomach at 2 mmHg above the minimal distending pressure for 90 min with a 200 ml liquid caloric meal (R) (Ensure ), 212 kCl, 14.1% protein, 22% fat, 63.9% carbohydrate) given at the 30th min. Gastric accommodation was expressed as the percentage of the increase of proximal gastric volume induced by the meal compared to the mean volume during the basal period.
Results: After H. pylori eradication, the proximal stomach volume after meal increased 229 +/- 48 ml (97
+/- 23%) significants grater than before eradication (141 +/- 52 ml or 41 +/- 18 %) (p <0.05). There were no significant differences of the gastric compliance, and gastric perception (first sensation and threshold of discomfort), evaluated before and after H. pylori eradication (p >0.05). There were significant improvements in global dyspeptic symptoms after H. pylori eradication.
Conclusions: H. pylori eradication improves gastric accommodation and global dyspeptic symptoms
in functional dyspepsia patients without significant changes of gastric compliance and gastric perception in response to mechanical distension. This finding suggests that H. pylori infection may be associated with the impaired gastric accommodation found in functional dyspepsia patients.
[Thai J Gastroenterol 2006; 7(2): 151-156] |
file/Thai-Journal-of-gastroenterology-vol-7-no-3-4641407.pdf