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Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia

Lack of influence of symptom subgroups andH. pylori-associated gastritis

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Abstract

The relative contributions of altered gastric motor function andHelicobacter pylori-associated active chronic gastritis to the pathogenesis of functional dyspepsia are controversial. We therefore evaluated scintigraphically the intragastric distribution and gastric emptying of a mixed solid-liquid meal in 75 patients with functional dyspepsia; patients were subdivided on the basis of both specific symptom clusters and the presence or absence ofH. pylori gastritis. Twenty-one (28%) patients displayed abnormal solid and/or liquid gastric emptying, with prolonged solid lag time the most prominent alteration detected. The number of patients with abnormal scintigraphic patterns increased to 36 (48%) when intragastric distribution parameters (fundal half-emptying time and antral maximal fraction) were examined. Although patients with reflux-like dyspepsia (N=36) demonstrated significantly slower rates of liquid emptying at 45 and 70 min and a higher prevalence of abnormal liquid intragastric distribution when compared to patients with motility-like dyspepsia (N=39) or to controls (N-34), the absolute differences were small and unlikely to be of clinical significance. Patients withoutH. pylori gastritis (N=50) demonstrated a significantly more prolonged solid lag time when compared to those withH. pylori gastritis (N=25), but the difference was small and there were no other differences between these two subgroups. We conclude that in patients with functional dyspepsia: (1) abnormal solid gastric emptying is present in less than one third; (2) assessment of parameters of intragastric distribution enables more subtle gastric motor dysfunction to be identified; and (3) neither dividing patients into symptom subgroups nor accounting for the presence or absence ofH. pylori gastritis has a major influence on the prevalence or type of gastric motor dysfunction.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia

    A. M. Scott FRACP,  J. E. Kellow MD, FRACP, B. Shuter MSc, H. Cowan RN, A.-M. Corbett NMT, J. W. Riley MD, FRACP, M. R. Lunzer FRCP, FRACP, R. P. Eckstein FRCPA, R. Höschl MD, S.-K. Lam MD, FRCP, FRACP & M. P. Jones PhD

  2. Department of Medicine, Royal North Shore Hospital, St. Leonards, Sydney, Australia

    A. M. Scott FRACP,  J. E. Kellow MD, FRACP, B. Shuter MSc, H. Cowan RN, A.-M. Corbett NMT, J. W. Riley MD, FRACP, M. R. Lunzer FRCP, FRACP, R. P. Eckstein FRCPA, R. Höschl MD, S.-K. Lam MD, FRCP, FRACP & M. P. Jones PhD

  3. Department of Gastroenterology, Royal North Shore Hospital, Sydney, Australia

    A. M. Scott FRACP,  J. E. Kellow MD, FRACP, B. Shuter MSc, H. Cowan RN, A.-M. Corbett NMT, J. W. Riley MD, FRACP, M. R. Lunzer FRCP, FRACP, R. P. Eckstein FRCPA, R. Höschl MD, S.-K. Lam MD, FRCP, FRACP & M. P. Jones PhD

  4. Department of Anatomical Pathology and Health Information Systems, Royal North Shore Hospital, Sydney, Australia

    A. M. Scott FRACP,  J. E. Kellow MD, FRACP, B. Shuter MSc, H. Cowan RN, A.-M. Corbett NMT, J. W. Riley MD, FRACP, M. R. Lunzer FRCP, FRACP, R. P. Eckstein FRCPA, R. Höschl MD, S.-K. Lam MD, FRCP, FRACP & M. P. Jones PhD

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  1. A. M. Scott FRACP
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  2. J. E. Kellow MD, FRACP
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  3. B. Shuter MSc
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  4. H. Cowan RN
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  5. A.-M. Corbett NMT
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  6. J. W. Riley MD, FRACP
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  7. M. R. Lunzer FRCP, FRACP
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  8. R. P. Eckstein FRCPA
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  9. R. Höschl MD
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  10. S.-K. Lam MD, FRCP, FRACP
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  11. M. P. Jones PhD
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Additional information

This study was supported by a grant from the Government Employees Medical Research Fund. Support of Janssen-Cilag Australia Pty. Ltd. is also gratefully acknowledged.

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Scott, A.M., Kellow, J.E., Shuter, B. et al. Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia. Digest Dis Sci 38, 2247–2254 (1993). https://doi.org/10.1007/BF01299904

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  • DOI: https://doi.org/10.1007/BF01299904

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