Gastric Accommodation In Patients With Functional Dyspepsia Assessed By Ultrasonography

Background and Aim: Recently non-invasive techniques, such as ultrasonography, have been developed to assess gastric accommodation and to investigate its relation to upper gastrointestinal sensations. The aim of this study was to investigate the validity and the optimal procedures of using ultrasonography in measurement of proximal gastric volumes and the relation between gastric volumes and sensations in patients with functional dyspepsia (FD) and healthy subjects (HS).Methods: Gastric accommodation was studied in in 31 FD patients and 20 HS after ingestion of a liquid nutrient (170kCal, 500ml)using ultrasonography for 60 minutes. Proximal gastric volume was measured by ultrasonography. The area in a sagittal section and the maximal diameter in an oblique frontal section were chosen as the main variables for calculating the gastric volume.Upper gastrointestinal sensations and air pockets in the gastric fundus were recorded and assessed at the same time.Results: Neither FD patients nor HS had to be excluded from the study due to air pockets (grade 3) in the gastric fundus impairing sonographic image quality. The postprandial proximal gastric volume in FD patients was lower than that in HS in most moments ( 0 min 149.87±27.94 vs182.84±26.63, P<0.01; 5 min 163.11±35.26 vs.194.98±30.39, P<0.01;10 min 152.59±27.81 vs.197.91±25.30,P<0.01;15 min 127.06±29.89 vs.175.24±33.99, P<0.01;20 min 102.84±25.54 vs.158.74±25.88, P<0.01;30min 91.33±20.85 vs 141.58±20.26, P<0.01).Impaired proximal gastric accommodation was observed in 14/31 (45.2%) FD patients. Compared with HS, the symptom score after ingestion of the meal in FD patients was significantly higher than that in HS. (5.44±2.63 vs. 0.93±1.00,P<0.01).Non-significant relation was found between impaired gastric accommodation and symptom scores.Conclusions: Patients with functional dyspepsia have impaired proximal gastric accommodation to a meal. Symptom scores are not directly associated with impaired gastric accommodation in FD patients. B ultrasonography is a feasible and non-invasive technique to assess change in gastric volume as a reflection of gastric accommodation...