J Neurogastroenterol Motil.  2020 Jan;26(1):96-105. 10.5056/jnm19072.

Postprandial Symptoms in Patients With Functional Dyspepsia and Irritable Bowel Syndrome: Relations to Ultrasound Measurements and Psychological Factors

Affiliations
  • 1Department of Clinical Medicine, University of Bergen, Bergen, Norway
  • 2National Center for Gastrointestinal Ultrasound, Department of Medicine, Haukeland University Hospital, Bergen, Norway
  • 3National Center for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway
  • 4Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway

Abstract

Background/Aims
Dyspeptic symptoms are common in patients with functional gastrointestinal (GI) disorders, and may be related to visceral hypersensitivity. We aim to explore the relation between visceral hypersensitivity by using an ultrasonographic meal test and questionnaires in patients with irritable bowel syndrome (IBS) and/or functional dyspepsia (FD).
Methods
Patients (FD, n = 94; IBS, n = 88; IBS + FD, n = 66, healthy controls [HC], n = 30) were recruited consecutively and examined with ultrasound of the proximal and distal stomach after drinking 500 mL of a low caloric meat soup, and scored dyspeptic symptoms on a visual analogue scale (0-100 mm) before and after the meal. Psychological symptoms were assessed by Visceral Sensitivity Index (GI specific anxiety, n = 58), and Eysenck’s Personality Questionnaire-neuroticism (EPQ-N, n = 203).
Results
Patients with IBS and/or FD reported higher levels of nausea, upper GI discomfort, and epigastric pain both before and after a liquid meal compared to HC (P < 0.001), and had a larger antral area in a fasting state, compared to HC. We found impaired accommodation in 33% of the patients with FD, however ultrasound measurements and symptom severity did not correlate. Symptoms of epigastric pain, fullness and upper GI discomfort positively correlated to Visceral Sensitivity Index and EPQ-N in a fasting state, but not postprandially.
Conclusions
Nausea, upper GI discomfort, and epigastric pain was common in patients with IBS and FD. Both patient groups had enlarged antral area in a fasting state compared to HC. Discomfort and pain were associated to GI specific anxiety and neuroticism in a fasting state.

Keyword

Anxiety; Gastrointestinal diseases; Nausea
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