SYMPTOMS AND VISCERAL PERCEPTION IN SEVERE FUNCTIONAL AND ORGANIC DYSPEPSIA

Background-Hypersensitivity of gastric afferent pathways may play an a etiological role in symptoms of functional dyspepsia. Aims-To determin e whether patients with severe organic dyspepsia (associated with tiss ue irritation/injury) and those with functional dyspepsia (no detectab le tissue irritation) differ in their perception of gastric distension and whether this difference is reflected in differences in their gast rointestinal and psychological symptoms. Methods-Perceptual thresholds , referral patterns, and gastraintestinal and psychological symptoms w ere compared in 23 patients with functional dyspepsia, 10 organic dysp eptics, and 15 healthy controls. Results-Fifteen (65%) functional dysp eptics and no organic dyspeptics had reduced perceptual thresholds far fullness, discomfort, or pain (odds ratio (OR) 19.56, 95% confidence interval (CI) 1.95 to 476.09, p=0.0017). Either reduced perceptual thr esholds or altered referral was found in 20 (87%) functional dyspeptic s and four (20%) organic dyspeptics (OR 10.0, 95% CI 1.34 to 89.54, p= 0.014). During sham distension fullness, discomfort and pain were repo rted by healthy controls, organic dyspeptics, and functional dyspeptic s. A sham response of pain but no other sensation was more frequent am ong functional dyspeptics (43%) than healthy controls (7%) (OR 10.77, 95% CI 1.10 to 257.35, p=0.026). Gastrointestinal and psychological sy mptoms and gastric compliance were similar in the functional and organ ic groups. Conclusions-Alterations in the perception of gastric disten sion distinguishes California, USA between functional and organic dysp epsia, while symptoms do not. A total of 87% of functional dyspeptics studied had evidence of altered visceral afferent function. In this st udy population, psychological abnormalities or changes in compliance d id not explain the findings.