Pressure-induced gastric accommodation studied with a new distension paradigm. Abnormally low accommodation rate in patients with functional dyspepsia

Abstract

Objective. A new distension paradigm, by which the gastric volume response to ramp-tonic distension can be analysed in detail, has been developed. The aim of this study was to investigate the applicability of this new paradigm in man, and to compare pressure-induced gastric accommodation in healthy volunteers (HV) and patients with functional dyspepsia (FD). Material and methods. Ten HV, and 11 FD patients were examined twice; once in the fasting state and once postprandially. Intragastric bag pressure was raised from 1 to 12 mmHg in 4 min (ramp phase) and then kept constant for 5 min (tonic phase). Results. Compared to HV, fasting FD patients had lower gastric accommodation rates (0.9±0.2 versus 2.5±0.4 ml/s, p=0.002), lower maximum volume (239±39 versus 428±64 ml, p=0.01) and a longer accommodation time (157±26 versus 92±15 s, p=0.03). A test meal prior to distension tended to normalize the response in FD patients. Conclusions. This new barostat paradigm allowed detailed analysis of short-term pressure-induced accommodation in man. Impaired gastric distension-induced accommodation is a novel abnormality in FD.

• Barostat
• dyspepsia
• functional gastrointestinal disorders
• gastric fundus
• relaxation