The Usefulness of Water-drinking Ultrasonography Combined Test for Evaluating Patients with Functional Dyspepsia

Tatyana Kugler

doi:10.4166/kjg.2015.66.2.92

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Kugler: The Usefulness of Water-drinking Ultrasonography Combined Test for Evaluating Patients with Functional Dyspepsia

Original Article

Korean J Gastroenterol 2015;66(2):92-97.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.66.2.92

The Usefulness of Water-drinking Ultrasonography Combined Test for Evaluating Patients with Functional Dyspepsia

Tatyana Kugler

Department of Internal Medicine, Bogomolets National Medical University, Kyiv, Ukraine

Correspondence to: Tatyana Kugler, Department of Internal Medicine, Bogomolets National Medical University, 03189, Lomonosova 52a str., app.141, Kyiv, Ukraine. Tel: +38-050-1414080, Fax: +38-050-1414080, E-mail: kugler2@mail.ru

Received 24 February 2015 Revised 24 June 2015 Accepted 6 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The major causes of functional dyspepsia (FD) are motility dysfunction and visceral hypersensitivity. Despite the large number of diagnostic tests, there are no convenient methods for evaluation of gastric functions. Therefore, this study was conducted to assess the relationship between the degree of dyspepsia and gastric accommodation, emptying, and sensitivity.

Methods

A total of 120 FD patients that met the Rome III criteria and 30 healthy volunteers were included in this cross-sectional study. The mean cross-sectional area of the fornix was measured to investigate fundic accommodation and gastric emptying during and after water intake. During the test, abdominal symptoms were evaluated using the 4-point Likert scale.

Results

The water-drinking ultrasonography combined test revealed impairment of gastric accommodation in FD after 1,000 mL of water intake, delayed emptying after 5 min of water intake and statistically significant hyperesthesia after 400 mL of water intake in the FD group compared with healthy controls (p<0.05). Postprandial distress syndrome (PDS) and overlap syndrome were independently associated with gut motor disturbances instead of epigastric pain syndrome (EPS) (p<0.01). Conclusions: The results of the present study suggest that the water-drinking ultrasonography combined test could be used for diagnosis of gastric motor and sensory dysfunction, particularly in PDS and EPS-PDS patients. This test is easy, well tolerated by the patient and can be widely applied in clinical practice.

Keywords: Accommodation, Gastric emptying, Visceral hypersensitivity, Early satiation

References

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3. Shimpuku M, Futagami S, Tajima N, et al. Impact of eating attitude and impairment of physical quality of life between tertiary clinic and primary clinic functional dyspepsia outpatients in Japan. J Neurogastroenterol Motil. 2014; 20:506–515.

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8. Ivashkin VT, Sheptulin AA, Lapina TL, et al. Guidelines of the Russian Gastroenterological Association on diagnostics and treatment of functional dyspepsia. RZHGGK. 2012; 22:80–92.

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Fig. 1.

Impairment of gastric accommodation in the functional dyspepsia (FD) patients. *p=0.031.

Fig. 2.

Delayed emptying in the functional dyspepsia (FD) patients. *p=0.002.

Fig. 3.

Visceral hypersensitivity in the functional dyspepsia (FD) patients. *p=0.047.

Fig. 4.

Prevalence of dyspeptic symptoms and Helicobacter pylori (%) in patients diagnosed with normal and impaired gastric accommodation.

Fig. 5.

Comparison of the prevalence defect motor gastric function (A) and visceral hypersensitivity (B) in patients with different functional dyspepsia subtypes using the χ²-test. Postprandial distress syndrome (PDS) and overlap have defective accommodation and/or significantly higher frequency of emptying than epigastric pain syndrome (EPS) (p<0.05). Visceral hypersensitivity is increased in overlap relative to PDS (p<0.001).

Table 1.

Gastric Accommodation and Visceral Hypersensitivity in Healthy Subjects and Functional Dyspepsia (FD) Patients

Water intake (mL)	Gastric accommodation (cm²)		Visceral hypersensitivity
Water intake (mL)	FD	Control	FD	Control
0	8.98±1.8	8.64±1.78	0	0
200	11.9±2.1	12.21±2.94	0.4±0.63	0.1±0.31
400	15.76±2.14	18.57±4.6	0.8±1.01	0.1±0.31^*
600	21.37±3.0	25.75±5.92	1.4±1.05	0.2±0.42
800	25.7±4.21	31.21±7.69	1.53±1.12	0.2±0.42
1,000	29.34±4.9	34.92±7.2^*	1.8±1.08	0.3±0.48

^* p<0.05.

Table 2.

Symptoms and Results of Water-drinking Ultrasonography Combined Test

Symptom	Impaired accomodation (%)	RR (95% CI)	p-value	Delayed emptying (%)	RR (95% CI)	p-value	Visceral sensitivity (%)	RR (95% CI)	p-value
Early satiation			<0.001			0.221			0.045
Yes (54)	39 (72.2)	2.45 (1.55–3.89)		24 (44.4)			33 (61.1)	1.52 (1.03–2.24)
No (66)	21 (31.8)			21 (31.8)			27 (40.9)
Postprandial fullness			0.006			0.392			0.697
Yes (81)	48 (59.2)	1.7 (1.21–2.38)		33 (40.7)			42 (51.9)
No (39)	12 (30.7)			12 (30.8)			18 (46.2)
Upper bloating			<0.001			0.811			0.010
Yes (51)	36 (70.6)	2.33 (1.45–3.75)		18 (35.3)			33 (64.7)	1.72 (1.14–2.62)
No (69)	24 (34.8)			27 (39.1)			27 (39.1)
Nausea			<0.001			0.921			0.076
Yes (46)	38 (82.6)	3.57 (1.86–6.88)		17 (36.9)			29 (63.1)
No (74)	28 (37.8)			28 (37.8)			33 (44.6)
Belching			0.134			0.086			0.705
Yes (45)	27 (60.0)			12 (26.7)			24 (53.3)
No (75)	33 (44.0)			33 (44.0)			36 (48.0)
Epigastric pain/burning			0.712			0.003			<0.001
Yes (69)	33 (47.8)			36 (52.2)	1.6 (1.20–2.14)		45 (65.2)	2.03 (1.40–2.93)
No (51)	27 (52.9)			12 (23.5)			15 (29.4)
Helicobacter pylori			0.001			0.921			0.001
Yes (46)	17 (36.9)	0.49 (0.33–0.74)		17 (36.9)			17 (36.9)	0.49 (0.33–0.74)
No (74)	51 (68.9)			28 (37.8)			51 (68.9)

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