A subset of functional dyspepsia patients report meal-related symptoms, possibly representing a pathophysiologically homogeneous subgroup.
Dr Bisschops and colleagues from Belgium established the time-course of symptoms in relation to meal ingestion.
The research team assessed the relationship between self-reported meal-related symptoms, and pathophysiological mechanisms in functional dyspepsia.
The team evaluated 218 functional dyspepsia patients who filled out a symptom questionnaire, including meal-induced aggravation.
|Intensity of each symptom was increased 15 minutes after the meal|
All patients underwent a gastric emptying breath test with severity scoring of 6 symptoms, including pain, fullness, bloating, nausea, burning and belching at each sampling.
In 129 patients, gastric sensitivity and accommodation were assessed by barostat.
The researchers found that the intensity of each functional dyspepsia symptom was significantly increased 15 minutes after the meal compared with the premeal score.
The research team noted that the intensity of each functional dyspepsia symptom remained elevated until the end of the measurement period.
The time-course of individual symptoms varied, with early peaks for fullness and bloating, intermediate peaks for nausea and belching and late peaks for pain and burning.
Meal-induced aggravation was reported by 79% of patients, and in these patients postprandial fullness, which peaked early, was the most intense symptom.
In patients without self-reported meal-induced aggravation, epigastric pain, which had a delayed peak, was the most intense symptom and they had a lower prevalence of gastric hypersensitivity.
Dr Bisschops’ team concluded, “Meal ingestion aggravates functional dyspepsia symptoms in the vast majority of patients, with symptom-specific time-courses.”
“Postprandial fullness is the most severe symptom in patients reporting aggravation by a meal, while it is pain in those not reporting meal-related symptoms.”