Relationship Between Gastric Emptying And Intragastric Distribution And Dyspepsia Symptoms In Patients With Functional Dyspepsia

Objective:By comparing the differences of gastric emptying on proximal stomach, distal stomach, total stomach and intragastric distribution, as well as the incidence of anxiety and depression between functional dyspepsia patients and healthy controls, studying relationship between the differences and dyspepsia symptoms in patients with functional dyspepsia (FD), and the psychological characteristics of FD.Methods:Based on Rome III criteria, we collected patients with FD in Outpatient department of Gastroenterology, the First Hospital of Lanzhou University, from October2012to September2013.Score for each dyspepsia symptom by using a questionnaire, symptoms including abdominal pain, burning, acid regurgitation or bitter sensation in the mouth or throat, bloating in upper abdominal, nausea, belching, vomiting, early satiety). A real-time ultrasonography was performed in73cases of FD patients and27healthy controls (HC) to examine the emptying of the each stomach area. The Zung self-rating anxiety scale(SAS)and the Zung self-rating depression scale(SDS) were employed to evaluate the anxiety mood and depression mood respectively of73FD patientsand27healthy controls.Results:1. As compared with that in HC group, the incidence of dyspepsia symptoms of FD patients were significantly increased except vomiting (P＜0.05～0.01).2. As compared with that in HC group, the half time of gastric emptying on proximal stomach (pTl/2), half time of gastric emptying on distal stomach (dTl/2) and gastric emptying half-time on total stomach (GT1/2) was prolonged significantly in FD (P＜0.05).The delay rate of proximal stomach, distal stomach and total stomach was significantly increased (P＜0.01).3. Each stomach area in FD group was larger than HC group at the five time points.60min after the meal, proximal stomach area, total stomach area in FD group were significantly increased (P＜0.01).90min after meal, proximal stomach area, distal stomach area and total stomach area in FD group were significantly increased (P＜0.05). 4. In FD patients, pT1/2and GT1/2were not correlated with each symptom, dTl/2and early satiety, body mass index were related (P＜0.05); GT1/2was negative correlated with age (P＜0.05). pT1/2was positively associated with proximal stomach area at90min (P＜0.01); dT1/2and60min,90min distal stomach area were positively correlated (P＜0.01); GT1/2and60min,90min total stomach area were positively correlated (P＜0.01).5. There were negative correlations between proximal gastric area at20,40min, total gastric area at40min and epigastric burning (P＜0.05). Distal gastric area at20,40min and early satiety were negative correlated (P＜0.05).6. Based emptying time, we divided FD group into non-delayed group and delayed group. In the postprandial60min,90min, proximal stomach area, distal stomach area, and total stomach area were larger than the non-delayed group(P＜0.05～0.01). There was no significant difference of the total symptom score and each symptom score between non-delayed group and delayed group (P＞0.05). Taking gastric emptying and symptoms for logistic regression analysis, the only relationship was between delayed distal gastric emptying and early satiety (P＜0.05).7. The incidence of anxiety and depression in FD patients were significantly higher than healthy controls (P＜0.01)8. The anxiety and depression scores in FD patients were significantly higher than healthy controls (P＜0.01)Conclusion:Abnormal gastric emptying existed in some patients with FD, delayed distal gastric emptying and early satiety were related. FD patients show the psychological characteristics of anxiety and depression.