NUTRIENT-SPECIFIC MODULATION OF GASTRIC MECHANOSENSITIVITY IN PATIENTS WITH FUNCTIONAL DYSPEPSIA

Intraduodenal lipid infusion induces symptoms and increases sensitivit y to gastric distension in patients with functional dyspepsia. To test whether these effects are specific for lipid, we compared the effects of intraduodenal infusions of either lipid or glucose on symptoms and gastric sensory and motor responses to gastric distension. Eighteen d yspeptic patients and nine controls were studied. The stomach was dist ended with a flaccid bag during isocaloric infusions (1 kcal/ml) of sa line and either 10% Intralipid (nine patients) or 26.7% glucose (nine patients) into the duodenum. Dyspeptic symptoms and sensory thresholds for epigastric fullness and discomfort were assessed. Gastric pressur e profiles during distensions were similar during lipid and glucose in fusions in patients and controls, but both were significantly lower th an during saline infusion. Lower volumes were required to induce fulln ess and discomfort in the patients compared with the controls. In the controls, the threshold volumes required to induce fullness and discom fort were greater during infusion of lipid and glucose than during sal ine infusion, but in the patients, the threshold volumes were increase d during glucose infusion but further reduced during lipid infusion. M oreover, in the patients, nausea was more common during lipid than glu cose infusion and did not occur during saline. The controls did not ex perience any symptoms during any infusion. In conclusion, intraduodena l lipid but not glucose sensitizes the stomach to distension in patien ts with functional dyspepsia but not in controls.