Study of Gastric Emptying and Orocecal Transit in Patients with Dysmotility like Functional Dyspepsia(DLFD)

Kang, Young Woo; Hwang, Jae Seok; Park, Soong Kook

Abstract

OBJECTIVES
Although DLFD is the most common subtype of functional dyspepsia in the Orient including Korea, previous studies on gastric emptying in DLFD patients are inconclusive and reports on small bowel transit in these patients are uncommon. This study is to evaluate the occurrence of delayed gastric emptying(GET) and orocecal transit time(OCTT) in DLFD patients.'
METHODS
98 DLFD patients without organic disease including diabetes (M:F=23:75, Mean Age=43.1(23-69)) and 67 normal subjects (20 for GET and 47 for OCTT, Mean Age=39.9(25-69)) without gastrointestinal problems were recruited. Solid phase gastric emptying was assessed by radionuclide scintigraphy using ADAC dual head gamma camera after ingestion of 99mTc labeled 425 calorie solid meal. OCTT was determined by the measuring exhaled hydrogen every 10 minutes for 3 hours after ingestion of 60.5 calorie potato soap with 20gm lactulose. OCTT was defined by the time interval between test meal to sustained increase in exhaled breath hydrogen by 10ppm above baseline. A delayed GET was defined as T1/2 above the mean value plus 1 SD of controls (74.6 +/- 17.6 min, M +/- SD) and a delayed OCTT as time exceeding the mean value plus 2 SD(81.9 +/- 13.3 min, MSD).
RESULTS
Among the 98 DLFD patients, only 7(7.1%) patients had a delayed GET(66.04 +/- 16.1 min vs 74.6 +/- 17.6 min, p=0.14) while a delayed OCTT was found in 36(36.7%) patients(100 +/- 32.9 min vs 81.9 +/- 13.3 min, p<0.01) and 3(3.1%) had both delayed GET and OCTT.
CONCLUSION
Delayed OCTT was more frequently observed than delayed GET which was not significant comparing to wide ranged controls. Small bowel transit rather than gastric emptying plays some role in pathophysiology of the patients with DLFD.