Temperature Can Influence Gastric Accommodation and Sensitivity in Functional Dyspepsia with Epigastric Pain Syndrome

2012 ◽  
Vol 58 (9) ◽  
pp. 2550-2555 ◽  
Author(s):  
Rui-Feng Wang ◽  
Zhi-Feng Wang ◽  
Mei-Yun Ke ◽  
Xiu-Cai Fang ◽  
Xiao-Hong Sun ◽  
...  
2017 ◽  
Vol 9 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Hiroshi Yamawaki ◽  
Seiji Futagami ◽  
Mako Wakabayashi ◽  
Noriko Sakasegawa ◽  
Shuhei Agawa ◽  
...  

Patients with functional dyspepsia, defined in the 2016 Rome IV criteria as bothersome clinical dyspepsia symptoms, experience markedly reduced quality of life. Several etiologies have been associated with the disorder. In the Rome IV criteria, the brain–gut axis was acknowledged as an important factor in the etiology of functional gastrointestinal (GI) disorders. The distinct subgroups of functional dyspepsia, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), are treated differently: acid secretion inhibitors are recommended with patients with EPS, whereas prokinetic drugs as mosapride and acotiamide are recommended for patients with PDS. A previous study has reported that proton pump inhibitors (PPIs) and H2-blockers were equally effective in functional dyspepsia. A new drug, acotiamide, a muscarinic antagonist and cholinesterase inhibitor, has been shown to improve gastric motility in rodents and dogs, and to reduce PDS symptoms in patients in double-blind multicenter studies. The pharmacological mechanisms of acotiamide remain unknown; whether acotiamide alters gastric emptying and gastric accommodation in patients with functional dyspepsia remains an open question. Other emerging treatment options include Rikkunshito, a herbal medicine that improves gastric emptying through 5-hydroxytryptamine (5-HT)2B-mediated pharmacological action, and tricyclic antidepressants (TCAs). Different drugs are needed to accommodate the clinical symptoms and etiology in individual patients.


Cephalalgia ◽  
2019 ◽  
Vol 39 (12) ◽  
pp. 1560-1568
Author(s):  
Michele Di Stefano ◽  
Ennio Pucci ◽  
Emanuela Miceli ◽  
Elisabetta Pagani ◽  
Natascia Brondino ◽  
...  

Background Migraine is a condition frequently associated with gastrointestinal disorders. Previous reports have shown the relationship between irritable bowel syndrome and migraine, but no data are yet available in patients with functional dyspepsia. We therefore evaluated whether alteration of gastric sensorimotor activity may be related to migraine. Methods Sixty patients affected by functional dyspepsia, 38 with postprandial distress syndrome and 22 with epigastric pain syndrome were enrolled in a cohort study. Presence and severity of dyspeptic symptoms, migraine presence and severity, gastric sensitivity thresholds during fasting and postprandial period, gastric accommodation and gastric emptying time were evaluated. Results In epigastric pain syndrome, 12/22 (54%) patients suffered from migraine and this condition was never correlated with meal ingestion. In postprandial distress syndrome patients, 29/38 (76%) suffered from migraine, in 26/29 (89%) its onset was considered as meal-related, and migraine severity was significantly correlated with postprandial modification of the gastric discomfort threshold (r = −0.73; p < 0.001). In patients with postprandial distress syndrome, in the subgroup with moderate to severe migraine, the severity of fullness and early satiation was significantly higher than in patients with mild or absent migraine. In patients with moderate to severe migraine, gastric accommodation, sensitivity thresholds and gastric emptying time were similar to patients with mild or no migraine. Conclusions In patients with functional dyspepsia and postprandial symptoms, migraine is a very frequent comorbidity. On clinical grounds, it is associated with an increased severity of fullness and early satiation and, on pathophysiological grounds, it seems correlated with postprandial hypersensitivity.


2014 ◽  
Vol 109 (10) ◽  
pp. 1631-1639 ◽  
Author(s):  
Michele Di Stefano ◽  
Emanuela Miceli ◽  
Paola Tana ◽  
Caterina Mengoli ◽  
Manuela Bergonzi ◽  
...  

2016 ◽  
Vol 63 (3.4) ◽  
pp. 230-235 ◽  
Author(s):  
Satoshi Shinozaki ◽  
Hiroyuki Osawa ◽  
Hirotsugu Sakamoto ◽  
Yoshikazu Hayashi ◽  
Alan Kawarai Lefor ◽  
...  

Objective was to study the level of tumor necrosis factor α (TNF-α) and interleukin 1α (IL-1α) in the blood of children with various forms of functional dyspepsia in accordance with various endoscopic changes of the gastric mucosa. Materials and methods. 79 school age children with functional dyspepsia were examined. The diagnosis was made in accordance with the recommendations of the Rome Criteria IV (2016). All patients underwent endoscopic examination of the esophagus, stomach and duodenum to exclude destructive changes of the mucous membrane. The level of TNF-α and IL-1α in the blood serum was determined by enzyme immunoassay. Statistical processing of the results obtained was performed using Microsoft Excel 2010. Results. The average level of TNF-α in the total group was 463.22±27.4 pg/ml, which statistically significantly exceeded this indicator in the control group (26.76±1.10 pg/ml; p<0.01). The IL-1α value in the total group was 148.6±6.06 pg/ml and was significantly higher in comparison with the control group (53.29±3.28 pg/ml; p<0.01). The level of proinflammatory cytokines in the group of children with epigastric pain syndrome was significantly higher than in the group of children with postprandial distress syndrome. Endoscopic examination showed the presence of unchanged mucous membrane in only 25.3% of children. Erythematous gastroduodenopathy was observed in 74.7% of children and was typical mainly for patients with epigastric pain syndrome (97.7%; p<0.05). Conclusions. The level of pro-inflammatory cytokines in children with functional dyspepsia is increased. When comparing the clinical variants of the disease, a significant increase in the level of TNFα, and IL-1α in children with epigastric pain syndrome was found. In the same group of children, endoscopic changes in the gastric mucosa were more pronounced. Further study of changes in the level of pro-inflammatory cytokines in children with functional dyspepsia may allow this to be used as one of the methods for the differential diagnosis of functional dyspepsia and chronic gastritis.


2014 ◽  
Vol 146 (5) ◽  
pp. S-157
Author(s):  
Yoon Jin Choi ◽  
Nayoung Kim ◽  
Jinjoo Kim ◽  
Sung Wook Hwang ◽  
Ryoung Hee Nam ◽  
...  

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