Gastric emptying in patients with gastroesophageal reflux disease and postprandial distress syndrome--preliminary results.
Journal - Przegla¸d lekarski (Poland )
BACKGROUND: Gastric motor disturbances are observed in patients with both Gastroesophageal Reflux Disease (GERD) forms - with (ERD) and without (NERD) esophageal inflammatory changes, and in Functional Dyspepsia (FD) patients, particularly in those with Postprandial Distress Syndrome (PDS). Gastric Helicobacter pylori (Hp) infection is often present in these entities. We tried to evaluate if there is any influence of Hp on gastric emptying (GE) in reflux and dyspeptic patients. MATERIAL AND METHODS: 25 GERD patients aged 45.7+/-13.1 yrs (10 NERD; 5 Hp+ and 5 Hp- and 15 ERD with grade A esophagitis according to Los Angeles classification; 5 Hp+ and 10 Hp-) and 15 PDS patients (5 Hp+ and 10 Hp-) aged 47.9+/-14.0 yrs participated in our study. All patients underwent upper gastrointestinal tract endoscopy, Hp status verification, stationary esopageal manometry, 24-hour ambulatory pH-metry and gastric scintigraphy with a liquid test meal. RESULTS: In general, both GERD groups and PDS patients had prolonged GE (T1/2 - NERD-54.9 +/- 6.3 [min], ERD-41.7 +/- 14.8 [min] and PDS-54.3 +/- 24.8 [min] vs. 35.2 +/- 13.9 [min] in control; p<0,05). According to Hp infection, we found in both NERD and PDS groups prolonged GE in Hp+ subjects in comparison to Hp-ones (respectively: T 1/2 - 66.5 +/- 21.2 [min] vs. 43.8 +/- 11.4 [min] in NERD; p<0.05; 63.5 +/- 29.0 [min] vs. 48.0 +/- 27.7 [min] in PDS; p<0.05). These differences were less pronounced in ERD subjects: 44.5 +/- 17.7 [min] Hp+ vs. 37.4 +/- 15.2 [min] in Hp- ERD; p>0.05). CONCLUSIONS: Both NERD and PDS patients had more decreased GE half-time compared to those with inflammatory esophageal changes. In particular groups, Hp infection was associated with slower GE rate and elongated T 1/2 in NERD and PDS group but with no effect in ERD patients.