Prokinetic effect of gut-oriented hypnosis on gastric emptying

BACKGROUND

No data are available on the effect of hypnosis on gastric emptying.

AIM

To determine the effect of a hypnosis session on gastric emptying and dyspeptic symptoms.

METHODS

We studied emptying by ultrasonography and epigastric sensations in 11 healthy subjects and in 15 patients affected by functional dyspepsia under three conditions according to a fixed schedule: (a) basal, (b) after cisapride and (c) during a 90 min hypnotic trance. Eight healthy subjects repeated an emptying study listening to relaxing music. Statistical analysis was performed using the Friedman test or RM-ANOVA.

RESULTS

In dyspeptics, the postprandial increase in the antral area was significantly smaller during the hypnosis trance than under the basal and the cisapride conditions. For the patients gastric emptying was significantly shortened by cisapride, and even more by hypnosis (basal 274 +/- 16.8 min; cisapride 227 +/- 13.2; hypnosis 150 +/- 9.7) whereas for healthy subjects it was shortened only by hypnosis. The repeated study in healthy subjects listening to relaxing music showed no significant difference compared with the basal. Epigastric sensations were improved in dyspeptics by hypnosis, but not by cisapride.

CONCLUSIONS

Gut-oriented hypnosis is effective in shortening gastric emptying both in dyspeptic and in healthy subjects.

Gastric emptying in patients with restricting and binge/purging subtypes of anorexia nervosa

OBJECTIVES

Gastrointestinal symptoms are common in anorexia and in bulimia nervosa, but their relationship with gastric dysmotility and their possible improvement with refeeding are still debated.

METHODS

Twenty-three anorexic patients (12 with the binge/purging and 11 with the restricting subtypes) were studied using an ultrasonographic gastric-emptying test, psychopathological questionnaires, and bowel symptom questionnaires, before and after 4 and 22 wk rehabilitation.

RESULTS

Gastric symptom scores were markedly higher in patients than in controls and improved significantly with treatment. On entry, compared to controls, gastric emptying was significantly delayed in restricters and purgers (357 +/- 25.3 and 360 +/- 13.0 min, respectively, mean +/- SEM; controls 207 +/- 9.1). After 4 and 22 wk of treatment, it improved in restricters (315 +/- 20.1 and 296 +/- 17.2 min, respectively), but not in purgers (337 +/- 14.3 and 335 +/- 15.9 min). No relationship was found between entry values of symptoms of gastric emptying and of psychopathological tests or between their variations over time.

CONCLUSIONS

Gastric emptying derangement and dyspeptic symptoms are present in both subtypes of anorexia nervosa patients. Long-term rehabilitation improves gastrointestinal symptoms, gastric emptying, and psychopathological distress in an independent manner, whereas short-term refeeding does not.

Effects of the administration of wheat bran biscuit: changes in the diet

We developed hard biscuit containing 30% wheat bran (WB biscuit) and administered it to 12 volunteers at 7.5 g/day (7.5 g group) or 15 g/day (15 g group) as wheat bran for 12 weeks. After 12 weeks, the dietary fiber intake from foods other than wheat bran decreased slightly in the both groups, in the 15 g group was the decrease notable especially, after the beginning of WB biscuit administration. We suggest that a closest attention to changes in dietary habit associated with intervention is needed in intervention studies using patients leading a normal life.

Increased insulin responses to ingested foods are associated with lessened satiety

In order to assess the relationship between metabolic responses and satiety, four men and five women ate two pairs of foods containing 50 g of available carbohydrate, ordinary and quick-cooking rice and high- and low-amylose puffed rice. Plasma glucose and insulin levels and satiety ratings were assessed over 2 h and food intake measured immediately thereafter. The area under the curve (AUC) of the 2-h glucose response was 1.6 times greater after quick-cooking rice than that for ordinary rice. Similarly, the glucose AUC for the low-amylose rice was 1.5 times higher than that of the high-amylose rice. Insulin responses followed the pattern of the glucose responses. Conversely, the satiety AUC was 1.5 times higher for ordinary rice than for the quick-cooking rice, and 1.5 times higher for high-amylose than for low-amylose rice. Food intake (g) immediately after each 2-h session was significantly related to both the satiety AUC and the last rating score, thereby corroborating the satiety ratings. A significant negative association was found between the individual insulin and satiety AUC responses to the four foods. These results suggest that increased rate of starch digestion and higher insulin responses are associated with lessened satiety.

Gastric emptying of solids is markedly delayed when meals are fried

We studied the effect of heat-treated fats on gastric emptying. Eight healthy asymptomatic volunteers (five males; age 28-41 years) ate on different days and in random order two meals identical in contents (pasta, tomato, beef, olive oil, carrots, orange, water; 870 kcal males, 700 kcal females; 47% of calories from carbohydrate, 36% from fat, 17% from protein), but cooked differently (fats fried or not). Ultrasound measurement of antral diameters was used to calculate basal antral section, its maximal dilation after the meal, the time necessary for total emptying, and the percent retention at hourly intervals. No difference was found in basal and maximal antral diameters after the two meals. On the contrary, total gastric emptying was significantly delayed after the fried meal [317.1 (24.12) vs 226.7 (18.4) min, mean (1 SEM); P < 0.002]. A significantly greater percentage of maximal antral distension was still present between 120 and 240 min after the fried meal. The glycemic response and hunger feeling were the same after the two meals, whereas there was a longer persistence of satiety and epigastric fullness after the fried meal. In conclusion, gastric emptying can be influenced not only by the meal content, but also by the way it is cooked.