GASTRIC ANTRAL MOTILITY IN FUNCTIONAL DYSPEPSIA - EFFECT OF MENTAL STRESS AND CISAPRIDE

Background: Disordered gastric antral motor activity may be induced by mental stress. The effect of cisapride on these abnormalities has pre viously not been investigated. Method: Ten healthy subjects and 19 pat ients with functional dyspepsia (FD) and erosive prepyloric changes pa rticipated in the study. Antral motility was recorded with real-time u ltrasonography after ingestion of 500 mi meat soup during i) a 4-min r est period, ii) 2.5 min of mental stress, and iii) a 4-min recovery pe riod. Patients and controls were studied after 3 days of treatment wit h 10 mg cisapride three times daily and placebo in a double-blind cros sover design. Results: Mean postprandial amplitude of antral contracti ons was lower in patients than controls (p < 0.001). Antral amplitude was reduced by mental stress in healthy persons (p < 0.001) but not in patients. Both fasting and postprandial antral areas were larger in F D patients than controls (p < 0.001 and p = 0.02, respectively). Cisap ride reduced the fasting (p < 0.001) and the postprandial (p = 0.05) a ntral area in the FD group but not in controls. The soup meal produced dyspeptic symptoms in 90% of the patients and in only 10% of the cont rols (p < 0.001). Cisapride had no significant effect on symptoms or a ntral contractions. Conclusions: Mental stress induced antral hypomoti lity in healthy subjects but not in patients with FD who had reduced m otility at base line. Cisapride reduced the enlarged fasting and postp randial antral areas in the patients but had no effect on amplitudes o f antral contractions or symptoms.