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Schamberg G, Calder S, Varghese C, Xu W, Wang WJ, Ho V, Daker C, Andrews CN, O'Grady G, Gharibans AA. Comparison of Gastric Alimetry ® body surface gastric mapping versus electrogastrography spectral analysis. Sci Rep 2023; 13:14987. [PMID: 37696955 PMCID: PMC10495352 DOI: 10.1038/s41598-023-41645-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023] Open
Abstract
Electrogastrography (EGG) non-invasively evaluates gastric motility but is viewed as lacking clinical utility. Gastric Alimetry® is a new diagnostic test that combines high-resolution body surface gastric mapping (BSGM) with validated symptom profiling, with the goal of overcoming EGG's limitations. This study directly compared EGG and BSGM to define performance differences in spectral analysis. Comparisons between Gastric Alimetry BSGM and EGG were conducted by protocolized retrospective evaluation of 178 subjects [110 controls; 68 nausea and vomiting (NVS) and/or type 1 diabetes (T1D)]. Comparisons followed standard methodologies for each test (pre-processing, post-processing, analysis), with statistical evaluations for group-level differences, symptom correlations, and patient-level classifications. BSGM showed substantially tighter frequency ranges vs EGG in controls. Both tests detected rhythm instability in NVS, but EGG showed opposite frequency effects in T1D. BSGM showed an 8× increase in the number of significant correlations with symptoms. BSGM accuracy for patient-level classification was 0.78 for patients vs controls and 0.96 as compared to blinded consensus panel; EGG accuracy was 0.54 and 0.43. EGG detected group-level differences in patients, but lacked symptom correlations and showed poor accuracy for patient-level classification, explaining EGG's limited clinical utility. BSGM demonstrated substantial performance improvements across all domains.
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Affiliation(s)
- Gabriel Schamberg
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
| | - Stefan Calder
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
| | - Chris Varghese
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - William Xu
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - William Jiaen Wang
- School of Medicine, Western Sydney University, Sydney, Australia
- Department of Gastroenterology and Hepatology, Campbelltown Hospital, Sydney, Australia
- Department of Gastroenterology and Hepatology, Townsville University Hospital, Townsville, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Vincent Ho
- School of Medicine, Western Sydney University, Sydney, Australia
- Department of Gastroenterology and Hepatology, Campbelltown Hospital, Sydney, Australia
| | - Charlotte Daker
- Department of Gastroenterology, North Shore Hospital, Auckland, New Zealand
| | | | - Greg O'Grady
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Alimetry Ltd, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Armen A Gharibans
- Department of Surgery, The University of Auckland, Auckland, New Zealand.
- Alimetry Ltd, Auckland, New Zealand.
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, United States.
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Suo S, Lai Y, Li M, Song Q, Cai J, Zhao J, Yang Q, Ung COL, Hu H. Phytochemicals, pharmacology, clinical application, patents, and products of Amomi fructus. Food Chem Toxicol 2018; 119:31-36. [PMID: 29802946 DOI: 10.1016/j.fct.2018.05.051] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 12/17/2022]
Abstract
Amomi fructus (A. fructus) (Sharen) is a well-known traditional Chinese medicine widely used to treat gastrointestinal diseases. It has high medical and economic values, which have been confirmed both in vitro and in vivo studies. This review highlights the phytochemicals, pharmacology, clinical application, patents, and products of A. fructus. More than 100 phytochemicals have been isolated and identified from A. fructus, mainly including volatile oils, saponins, flavonoids, organic acids, inorganic ingredients, and polysaccharides. The main pharmacology of gastrointestinal protection, anti-inflammatory activity, analgesic activity, antidiarrheal activity, antibacterial activity, anti-microbial activity and hypoglycemic activity have been confirmed. The main clinical applications include functional digestion disorder, gastritis, helicobacter pylori infection in children and treatment of mastitis. There are 23 patents and 405 different drug products of A. fructus.
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Affiliation(s)
- Sizhuo Suo
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Yunfeng Lai
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Meng Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Qirui Song
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Jing Cai
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Jing Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Qing Yang
- State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu City, Sichuan Province, China.
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao.
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Zeng F, Lan L, Tang Y, Liu M, Liu X, Song W, Li Y, Qin W, Sun J, Yu S, Gao X, Tian J, Liang F. Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia. Neurogastroenterol Motil 2015; 27:559-68. [PMID: 25693969 DOI: 10.1111/nmo.12532] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 01/26/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND To investigate the similarities and differences in cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia (FD). METHODS Twenty right-handed FD patients were enrolled and randomized divided into two groups. Each patient received 20 sessions' electro-acupuncture treatment. The acupoints used in Group A were four acupoints on the Stomach Meridian, and the acupoints used in Group B were four acupoints on the Gallbladder Meridian. PET-CT scans were performed before and after acupuncture treatment to record the changes of cerebral glycometabolism. KEY RESULTS After treatment, the dyspepsia symptoms and the quality of life (QOL) of the patients in each group were significantly improved (p < 0.05) and there was insignificant difference in efficacy between the two groups (p > 0.05). In Group A, deactivation in brainstem, bilateral anterior cingulate cortex (ACC) and cerebellum, left superior medial frontal gyrus, orbital frontal cortex (OFC), and thalamus, etc., and activation in bilateral middle cingulate cortex (MCC), precuneus and lingual gyrus, etc. were observed. In Group B, deactivation in brainstem, bilateral thalamus, putamen, ACC, postterior cingulate cortex, hippocampus and cerebellum, etc., and activation in bilateral MCC, precuneus, left OFC, etc. were observed (p < 0.05, Family-wise error corrected). CONCLUSIONS & INFERENCES Different acupoints have similar clinical efficacy but relatively different cerebral responses. The influence on the sensory transduction regions (brainstem and thalamus) and visceral modulation regions might be the common mechanism of different acupoints treating for FD, and the modulation on some emotion/cognition-related areas (e.g., prefrontal cortex) is the potential difference between the different acupoints.
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Affiliation(s)
- F Zeng
- Acupunture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Pasalar M, Choopani R, Mosaddegh M, Kamalinejad M, Mohagheghzadeh A, Fattahi MR, Zarshenas MM, Jafari P, Lankarani KB. Efficacy of Jollab in the Treatment of Depression in Dyspeptic Patients. J Evid Based Complementary Altern Med 2015; 20:104-8. [PMID: 25587004 DOI: 10.1177/2156587214563542] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The current study aimed to evaluate the efficacy of jollab, a well-known beverage from traditional Persian medicine in the treatment of depression among patients suffering from functional dyspepsia. In a randomized, double-blind, placebo-controlled trial, a pair of 80 patients were enrolled in 2 parallel groups as Jollab and placebo. The Beck Depression Inventory–II questionnaire was used for the assessment. At all, 133 patients enrolling in the treatment and placebo groups ended the protocol. According to the outcomes, changes in scores between the 2 groups were statistically significant at the end of trial ( P ≤ .001). Taken as a whole, treatment group was significantly more effective than the placebo. Focusing on nutritional and pharmaceutical properties, jollab may be introduced not only as a medication for depression and allied ailment but also a pleasant daily drink.
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Affiliation(s)
- Mehdi Pasalar
- The School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rasool Choopani
- The School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mosaddegh
- Traditional Medicine and Materia Medica Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamalinejad
- Department of Pharmacognosy, School of Pharmacy, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolali Mohagheghzadeh
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M. Zarshenas
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
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Zeng F, Qin W, Yang Y, Zhang D, Liu J, Zhou G, Sun J, Lu S, Tang Y, Chen Y, Lan L, Yu S, Li Y, Gao X, Gong Q, Tian J, Liang F. Regional brain structural abnormality in meal-related functional dyspepsia patients: a voxel-based morphometry study. PLoS One 2013; 8:e68383. [PMID: 23844192 PMCID: PMC3699561 DOI: 10.1371/journal.pone.0068383] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 05/29/2013] [Indexed: 12/19/2022] Open
Abstract
Background and Aims Brain dysfunction in functional dyspepsia (FD) has been identified by multiple neuroimaging studies. This study aims to investigate the regional gray matter density (GMD) changes in meal-related FD patients and their correlations with clinical variables, and to explore the possible influence of the emotional state on FD patients’s brain structures. Methods Fifty meal-related FD patients and forty healthy subjects (HS) were included and underwent a structural magnetic resonance imaging scan. Voxel-based morphometry analysis was employed to identify the cerebral structure alterations in meal-related FD patients. Regional GMD changes' correlations with the symptoms and their durations, respectively, have been analyzed. Results Compared to the HS, the meal-related FD patients showed a decreased GMD in the bilateral precentral gyrus, medial prefrontal cortex (MPFC), anterior cingulate cortex (ACC) and midcingulate cortex (MCC), left orbitofrontal cortex (OFC) and right insula (p<0.05, FWE Corrected, Cluster size>50). After controlling for anxiety and depression, the meal-related FD patients showed a decreased GMD in the bilateral middle frontal gyrus, left MCC, right precentral gyrus and insula (p<0.05, FWE Corrected, Cluster size>50). Before controlling psychological factors, the GMD decreases in the ACC were negatively associated with the symptom scores of the Nepean Dyspepsia Index (NDI) (r = −0.354, p = 0.048, Bonferroni correction) and the duration of FD (r = −0.398, p = 0.02, Bonferroni correction) respectively. Conclusions The regional GMD of meal-related FD patients, especially in the regions of the homeostatic afferent processing network significantly differed from that of the HS, and the psychological factors might be one of the essential factors significantly affecting the regional brain structure of meal-related FD patients.
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Affiliation(s)
- Fang Zeng
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Qin
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Yue Yang
- Psychosomatic Medicine Department, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China
| | - Danhua Zhang
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jixin Liu
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Guangyu Zhou
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Jinbo Sun
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi, China
| | - Shengfeng Lu
- Key Laboratory of Acupuncture and Medicine Research of Minister of Education, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangshu, China
| | - Yong Tang
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuan Chen
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lei Lan
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Shuguang Yu
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Li
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xin Gao
- Biology Department, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail: (FL); (XG)
| | - Qiyong Gong
- Department of Radiology, The Center for Medical Imaging, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jie Tian
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi, China
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Fanrong Liang
- The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- * E-mail: (FL); (XG)
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Abstract
In this Review, after a brief historical introduction, we first provide an overview of epidemiological studies that demonstrate an association between functional dyspepsia and psychological traits, states or psychiatric disorders. These studies suggest an important intrinsic role for psychosocial factors and psychiatric disorders, especially anxiety and depression, in the aetiopathogenesis of functional dyspepsia, in addition to their putative influence on health-care-seeking behaviour. Second, we describe pathophysiological evidence on how psychosocial factors and psychiatric disorders might exert their role in functional dyspepsia. Novel insights from functional brain imaging studies regarding the integration of gut-brain signals, processed in homeostatic-interoceptive brain regions, with input from the exteroceptive system, the reward system and affective and cognitive circuits, help to clarify the important role of psychological processes and psychiatric morbidity. We therefore propose an integrated model of functional dyspepsia as a disorder of gut-brain signalling, supporting a biopsychosocial approach to the diagnosis and management of this disorder.
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Vasant DH, Payton A, Mistry S, Thompson DG, Hamdy S. The val66met polymorphism of brain-derived neurotrophic factor is associated with human esophageal hypersensitivity. Neurogastroenterol Motil 2013; 25:162-e85. [PMID: 23020799 DOI: 10.1111/nmo.12021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Recent evidence implicates brain-derived neurotrophic factor (BDNF) in visceral hypersensitivity and pain in functional gastrointestinal disorders. We hypothesized that presence of the val66met polymorphism in the BDNF gene would be linked to increased esophageal sensitivity to electrical stimulation. METHODS A total of 39 healthy volunteers (20 males, mean age 30) compliant with inclusion criteria after screening procedures were genotyped for BDNF polymorphisms and completed an Hospital Anxiety and Depression Scale (HADS) questionnaire. Sensory (ST) and pain (PT) thresholds in the proximal (PE) and distal (DE) esophagus were determined using electrical stimuli to a swallowed intraluminal catheter with bipolar electrodes by an investigator blinded to the subjects' genotype. For comparison, somatic ST and PT (hand and foot) were also tested. HADS scores together with esophageal and somatic thresholds were then correlated with BDNF polymorphism status. KEY RESULTS Eleven of 39 (28%) volunteers had at least one Met allele (Met carriers). When compared with Val/Val, Met carriers had lower esophageal PT (Median PT [mA]: Val/Val vs Met carriers, PE; 49.4 vs 44.3, P = 0.033, DE: 63.8 vs 55.4, P = 0.045) with higher proportion of Val/Val subjects in the upper quartile for PT in both PE (P = 0.021) and DE (P = 0.033), yet similar somatic PT (Median PT [mA] Hand; 33.6 vs 38.0, P = 0.22, Foot; 44.7 vs 44.0, P = 0.48). Sensitivity results were independent of anxiety (P = 0.66) and depression (P = 0.33) scores. CONCLUSIONS & INFERENCES val66met BDNF polymorphisms are associated with increased esophageal sensitivity to experimental electrical stimulation. Thus, BDNF genotype may be a useful biomarker for electrical sensitivity in the healthy human esophagus.
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Affiliation(s)
- D H Vasant
- Gastrointestinal Centre, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Salford Royal NHS Foundation Trust, Salford, UK
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Ghoshal UC, Singh R, Chang FY, Hou X, Wong BCY, Kachintorn U. Epidemiology of uninvestigated and functional dyspepsia in Asia: facts and fiction. J Neurogastroenterol Motil 2011; 17:235-44. [PMID: 21860815 PMCID: PMC3155059 DOI: 10.5056/jnm.2011.17.3.235] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Revised: 06/15/2011] [Accepted: 06/15/2011] [Indexed: 01/06/2023] Open
Abstract
Dyspepsia is a syndrome consisting of epigastric pain, burning, fullness, discomfort, early satiety, nausea, vomiting and belching. Functional dyspepsia (FD) is diagnosed if upper gastrointestinal endoscopy does not show structural abnormality explaining these symptoms. 8%-30% and 8%-23% of Asian people suffer from of uninvestigated dyspepsia and FD, respectively. Most patients with uninvestigated dyspepsia are found to have FD. Patients with FD are usually young and there is no predilection to any gender. Overlap of FD with other functional bowel diseases such as irritable bowel syndrome and gastroesophageal reflux disease is common in Asia. Cultural difference in reporting of symptoms of dyspepsia is well-known. Moreover, dietary factors, socio-cultural and psychological issues, gastrointestinal infection including that caused by Helicobacter pylori, frequency of organic diseases such as peptic ulcer and gastric cancer responsible for dyspeptic symptoms in the study population may also influence epidemiology of dyspepsia. There is considerable heterogeneity in the above issues among different Asian countries. More studies on epidemiology of FD are needed in Asia.
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Affiliation(s)
- Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Rajan Singh
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Full-Young Chang
- Division of Gastroenterology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Udom Kachintorn
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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De la Roca-Chiapas JM, Solís-Ortiz S, Fajardo-Araujo M, Sosa M, Córdova-Fraga T, Rosa-Zarate A. Stress profile, coping style, anxiety, depression, and gastric emptying as predictors of functional dyspepsia: a case-control study. J Psychosom Res 2010; 68:73-81. [PMID: 20004303 DOI: 10.1016/j.jpsychores.2009.05.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 05/03/2009] [Accepted: 05/26/2009] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether gastric emptying, stomach peristaltic frequencies, stress profile, depressive symptoms, anxiety, and salivary cortisol levels could predict functional dyspepsia (FD). METHODS Magnetogastrography (MGG) was used to measure gastric emptying time and the gastric peristaltic frequencies in 15 patients with FD diagnosis and in 17 healthy volunteers. In all the participants, stress profile, anxiety, and depressive symptoms were evaluated by means of standardized questionnaires, and morning salivary samples were collected for the measurement of cortisol levels. A univariate logistic regression model was used to examine the probability of the measured variables to predict the presence of FD. RESULTS The univariate logistic regression model showed that the half-time of gastric emptying (OR=1.16 P=.01); the subscale of stress items (OR=1.08, P=.003); negative appraisal of subscale coping strategies (OR=1.03, P=0.007); anxiety (OR=1.05, P=.01); and depression (OR=1.23, P=.02) had a significant predictive value for the presence of FD. However, by applying the stricter multiple comparison criteria, only stress, negative appraisal, and anxiety arose as predictors of FD. The FD patients compared with healthy volunteers showed significantly elevated half-time of gastric emptying (P<.0006), high scores in the subscales of stress (P<.000003), in behavior type "A" (P<.04), in coping styles (P<.008), in depression (P<.0004), and in anxiety (P<.0002). CONCLUSIONS These findings indicate that psychosocial stress, mood symptoms, and coping style are predictors of FD. The stress shows high sensibility and specificity in the patients with FD, indicating a contribution in the etiopathogenesis of dyspepsia.
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Affiliation(s)
- José M De la Roca-Chiapas
- División de Ciencias e Ingenierías, Departamento de Ingeniería Física, Universidad de Guanajuato, León, Guanajuato, México.
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Abstract
OBJECTIVE The objectives of this study were to assess differences in gastric slow waves measured by a newly approved multichannel electrogastrogram (EGG) device between patients with functional dyspepsia (FD) and healthy controls. MATERIALS AND METHODS Gastric myoelectrical activity was measured by multichannel EGG for 1 hour preprandially and for 2 hours postprandially in 72 FD patients and 16 healthy volunteers. Computerized spectral analysis methods were used to compute various EGG parameters. RESULTS (1) Multichannel EGG was abnormal in 83.3% of patients. (2) The regularity of the gastric slow wave was significantly lower in the FD patients in both fasting and fed states; the lowest regularity was seen in channel 3. (3) There was a significantly higher incidence of arrhythmia and tachygastria in FD patients. The highest percentage of arrhythmia and tachygastria were both seen in channel 3. (4) The FD patients showed a significantly lower percentage of slow wave coupling among the 4-channel EGGs in the fed state. (5) The postprandial-preprandial power ratio was significantly less in FD patients. (6) These patients had high symptom scores particularly to nausea, upper abdominal pain, and bloating. However, no significant correlation was noted between the EGG parameters and the symptoms. CONCLUSIONS Gastric myoelectrical activity is impaired in most patients with FD. The impairment is reflected as a decreased percentage of normal slow waves and an excessive amount of arrhythmia as well as an abnormal spatial distribution of EGG parameters among the 4 channels, suggesting an impaired coordination of gastric slow waves.
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Zhang H, Chen S, Qin F, Huang X, Ren P, Gu X. Simultaneous determination of 12 chemical constituents in the traditional Chinese Medicinal Prescription Xiao-Yao-San-Jia-Wei by HPLC coupled with photodiode array detection. J Pharm Biomed Anal 2008; 48:1462-6. [DOI: 10.1016/j.jpba.2008.09.023] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 09/15/2008] [Accepted: 09/15/2008] [Indexed: 01/27/2023]
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12
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Takamori KI, Mizuta Y, Takeshima F, Akazawa Y, Isomoto H, Ohnita K, Ohba K, Omagari K, Shikuwa S, Kohno S. Relation among plasma ghrelin level, gastric emptying, and psychologic condition in patients with functional dyspepsia. J Clin Gastroenterol 2007; 41:477-83. [PMID: 17450030 DOI: 10.1097/01.mcg.0000225614.94470.47] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND GOALS Neurohormonal factors might play a role in the pathogenesis of functional dyspepsia (FD). However, the role of ghrelin, a gastrointestinal hormone that stimulates gastric motility, in FD is not yet clearly defined. The present study was designed to investigate plasma ghrelin levels and their relation with gastric emptying and psychologic status in FD. METHODS Sixteen patients with FD of the dysmotility type and 19 healthy controls were enrolled in the study. Plasma active and desacyl ghrelin concentrations before and after test meal were measured by enzyme-linked immunosorbent assay. Gastric emptying and psychologic condition were studied using C acetate breath test and questionnaires, respectively. RESULTS Gastric emptying was significantly prolonged in patients with FD compared with controls. Fasting desacyl and total ghrelin levels were significantly lower in FD patients than in controls, but fasting active ghrelin levels and postprandial levels of ghrelin in both forms were similar between the 2 groups. Fasting total ghrelin levels in FD patients did not differ from the postprandial levels, in contrast to what was found for controls. There was no significant association among gastric emptying, plasma ghrelin levels, and psychologic factors in FD patients. CONCLUSIONS Total secretory ability or metabolic condition of ghrelin may be altered in patients with FD. This seems to play a role in the pathophysiology of dysmotility type FD, independent of delayed gastric emptying or psychologic disorders.
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Affiliation(s)
- Ken-Ichi Takamori
- Second Department of Internal Medicine, Nagasaki University School of Medicine, National Nagasaki Medical Center, Nagasaki, Japan
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da Silva RA, Pinheiro RT, da Silva RA, Horta BL, Moraes I, Faria AD. Dispepsia funcional e depressão como fator associado. ARQUIVOS DE GASTROENTEROLOGIA 2006; 43:293-8. [PMID: 17406758 DOI: 10.1590/s0004-28032006000400010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Accepted: 08/10/2006] [Indexed: 01/28/2023]
Abstract
OBJETIVO: Avaliar a associação entre depressão e dispepsia funcional. PACIENTES E MÉTODOS: Estudo transversal onde foram avaliados 348 pacientes com diagnóstico de dispepsia no Ambulatório de Gastroenterologia do Hospital Universitário de Pelotas, RS, cidade de médio porte do sul do Brasil, durante o período de 1 ano (de março de 2001 a março de 2002). Após o diagnóstico de dispepsia avaliou-se a presença de depressão, tanto em pacientes com dispepsia funcional, quanto naqueles com dispepsia orgânica. Utilizou-se a análise univariada para descrição das freqüências das variáveis de interesse e da análise bivariada, com o teste qui-quadrado, para comparação entre proporções das variáveis categóricas. A técnica da regressão logística foi utilizada para estabelecer a chance dos pacientes com depressão apresentarem dispepsia funcional e para controlar o efeito das variáveis intervenientes sobre a variável de desfecho RESULTADOS: Evidenciaram maior prevalência de deprimidos entre os pacientes com dispepsia funcional (30,4%) em relação àqueles com dispepsia orgânica (11,2%). As mulheres apresentaram maior chance de dispepsia funcional (OR: 1,74, IC 95%, 1,05-2,89) e, em relação à idade, os intervalos entre 31 e 50 anos (OR: 0,28 IC 95%, 0,13-0,54) e de 51 a 60 anos (OR: 0,41, IC 95%, 0,17-0,96) mostraram efeito protetor, ou seja, indivíduos nessas faixas etárias têm menor risco de apresentar dispepsia funcional. Após a análise multivariada, pacientes deprimidos apresentaram chance três vezes maior de co-morbidade com dispepsia funcional do que pacientes não-deprimidos (OR 3,13; IC 95%; 1,71-5,74).
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Mizuta Y, Shikuwa S, Isomoto H, Mishima R, Akazawa Y, Masuda JI, Omagari K, Takeshima F, Kohno S. Recent insights into digestive motility in functional dyspepsia. J Gastroenterol 2006; 41:1025-40. [PMID: 17160514 DOI: 10.1007/s00535-006-1966-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 10/02/2006] [Indexed: 02/04/2023]
Abstract
Functional gastrointestinal disorders, such as functional dyspepsia (FD) and irritable bowel syndrome, are common pathologies of the gut. FD is a clinical syndrome defined as chronic or recurrent pain or discomfort of unknown origin in the upper abdomen. The pathophysiological mechanisms responsible for FD have not been fully elucidated, but new ideas regarding its pathophysiology and the significance of the pathophysiology with respect to the symptom pattern of FD have emerged. In particular, there is growing interest in alterations in gastric motility, such as accommodation to a meal or gastric emptying, and visceral sensation in FD. The mechanisms underlying impaired gastroduodenal motor function are unclear, but possible factors include abnormal neurohormonal function, autonomic dysfunction, visceral hypersensitivity to acid or mechanical distention, Helicobacter pylori infection, acute gastrointestinal infection, psychosocial comorbidity, and stress. Although the optimum treatment for FD is not yet clearly established, acid-suppressive drugs, prokinetic agents, eradication of H. pylori, and antidepressants have been widely used in the management of patients with FD. The therapeutic efficacy of prokinetics such as itopride hydrochloride and mosapride citrate in the treatment of FD is supported by the results of relatively large and well-controlled studies. In addition, recent research has yielded new therapeutic agents and modalities for dysmotility in FD, including agonists/antagonists of various sensorimotor receptors, activation of the nitrergic pathway, kampo medicine, acupuncture, and gastric electric stimulation. This review discusses recent research on the pathophysiology of and treatment options for FD, with special attention given to digestive dysmotility.
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Affiliation(s)
- Yohei Mizuta
- Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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Xing J, Qian L, Chen J. Experimental gastric dysrhythmias and its correlation with in vivo gastric muscle contractions. World J Gastroenterol 2006; 12:3994-8. [PMID: 16810746 PMCID: PMC4087708 DOI: 10.3748/wjg.v12.i25.3994] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the direct correlation between gastric dysrhythmias and in vivo gastric muscle tone.
METHODS: Five healthy dogs were implanted with 4 pairs of electrodes along the greater curvature, with a strain gauge (SG) being sutured parallel to the distal electrodes (2 cm above the pylorus). Intravenous vasopressin was given to induce gastric dysrhythmia. The percentage of regular slow waves and SG energy were calculated.
RESULTS: (1) the regularity of gastric myoelectric activity (GMA) was reduced during and after infusion of vasopressin; (2) SG energy was significantly decreased during the infusion of vasopressin; (3) the decrease in SG energy was well correlated with the reduction in GMA regularity; (4) SG energy was negatively correlated with bradygastria and tachygastria.
CONCLUSION: Vasopressin inhibits gastric contractions and impairs gastric slow waves; gastric dysrhythmias are associated with the reduced antral muscle contractions, and are indicative of antral hypomotility.
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Affiliation(s)
- Jinhong Xing
- Veterans Research Foundation, Oklahoma City, Oklahoma, United States
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van Kerkhoven LAS, van Rossum LGM, van Oijen MGH, Tan ACITL, Witteman EM, Laheij RJF, Jansen JBMJ. Alexithymia is associated with gastrointestinal symptoms, but does not predict endoscopy outcome in patients with gastrointestinal symptoms. J Clin Gastroenterol 2006; 40:195-9. [PMID: 16633119 DOI: 10.1097/00004836-200603000-00005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Alexithymia, where a person has difficulty in distinguishing between emotions and bodily sensations, is considered to be a character trait and a vulnerability factor for various psychosomatic disorders. Assessing alexithymia in patients with gastrointestinal (GI) symptoms before endoscopy might therefore be useful in selecting patients who are more prone to functional GI disorders. GOAL To determine whether alexithymia might be a useful factor in predicting GI endoscopy outcomes. STUDY Patients referred for endoscopy between February 2002 and February 2004 were enrolled. They were asked to report alexithymia on the Toronto Alexithymia Scale-20 2 weeks before endoscopy. Information about endoscopic diagnoses was obtained from medical files. RESULTS A total of 1141 subjects was included (49% male), of whom 245 (21%) reported alexithymia. There was no difference in mean+/-SD alexithymia scores between patients with (51+/-12) and without (50+/-12) an endoscopic organic abnormality at GI endoscopy. When divided into subgroups, according to the most prominent finding at either upper or lower GI endoscopy, there was no association with alexithymia. Patients with alexithymia reported a worse sensation of GI symptoms during the last weeks before enrollment in the study (mean+/-SD symptom severity score: 42+/-34 vs. 34+/-30, respectively; P<0.01). CONCLUSIONS Alexithymia is not associated with endoscopic findings, and has therefore no additive value in predicting endoscopy outcomes. Patients with alexithymia more often present with a higher number and more severe GI symptoms.
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Affiliation(s)
- Lieke A S van Kerkhoven
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Misu N, Kamiya T, Kobayashi Y, Hirako M, Nagao T, Shikano M, Matsuhisa E, Ando T, Adachi H, Kimura G. Effects of oral glucose intake on gastric myoelectrical activity and gastric emptying. J Smooth Muscle Res 2005; 40:169-76. [PMID: 15655304 DOI: 10.1540/jsmr.40.169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To investigate the effect of oral glucose intake on gastric motility, we measured gastric myoelectrical activity and gastric emptying on two test conditions: 1) glucose intake and 2) water intake in the same 10 healthy male volunteers (20 to 29 years old). Gastric motility was evaluated with cutaneous-recorded electrogastrography (EGG) for 30 min both on fasting and after glucose or water intake, while gastric emptying was measured using acetaminophen-absorption method. There were no significant changes in EGG dominant frequency after water intake, but the frequency increased significantly after glucose intake. A postprandial dip (i.e., a transient decrease in frequency immediately after the food intake) was observed in 3 subjects after water intake and in 8 subjects following glucose intake. The EGG power ratio was significantly larger after glucose than water intake, with delayed gastric emptying in the former case. These results suggest that glucose is one of the components responsible for postprandial gastric motility.
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Affiliation(s)
- Naoko Misu
- Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya 467-8601, Japan.
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Kamiya T, Kobayashi Y, Misu N, Hirako M, Adachi H, Nagao T, Shikano M, Matsuhisa E, Ando T, Kimura G. Gastric myoelectrical activity in patients with recurrent gastric or duodenal ulcers. J Smooth Muscle Res 2003; 39:1-10. [PMID: 12889851 DOI: 10.1540/jsmr.39.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to characterize gastric myoelectrical activity in patients with recurrent gastric ulcer (GU) or duodenal ulcer (DU), and to compare gastric motility between these two groups of patients. Studies were performed in 59 patients with recurrent active peptic-ulcer disease as diagnosed by gastrointestinal endoscopy: 31 patients had a GU and 28 patients had a DU. Gastric myoelectrical activity was evaluated by cutaneous electro-gastrography (EGG). The following EGG parameters were assessed: the percentage of normogastria (regular 2.4-3.6 cpm slow waves); the EGG power ratio; and the occurrence of a postprandial dip (PD), which is the transient decrease in EGG frequency after a meal. In the GU group, no significant change occurred in the percentage of normogastria or in the EGG power ratio observed after treatment with a proton-pump inhibitor. During the healed stage, the occurrence of PD remained unchanged. In contrast, in the DU group, the percentage of normogastria and the EGG power ratio were significantly increased after treatment. Moreover, during the healed stage, the occurrence of PD significantly increased compared with that during the active stage. These findings suggest that abnormal gastric myoelectrical activity plays an important role in the pathophysiology of recurrent GU rather than DU.
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Affiliation(s)
- Takeshi Kamiya
- Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Science, Nagoya 467-8601, Japan.
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