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Hypersensitivity to acid in ulcer-like functional dyspepsia.

Son HJ, Rhee PL, Kim JJ, Koh KC, Paik SW, Rhee JC - Korean J. Intern. Med. (1997)

Bottom Line: Twelve patients with ulcer-like functional dyspepsia (5 male, 7 female, mean age 41.0 years old, 7 with mild chronic superficial gastritis, 2 with metaplastic gastritis and 3 with normal endoscopic findings) and seven healthy control subjects (3 male, 4 female, mean age 36.0 years old, 7 with normal endoscopic findings) participated in the study.After overnight fasting, a nasogastric sump tube was inserted and its tip was positioned in the antrum under fluoroscopic guidance.The test was considered positive only if similar pain developed-similar to that experienced by the patient under nonstudy condition- during the administration.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sung Kyun Kwan University, Seoul, Korea.

ABSTRACT

Objectives: The mechanism of pain sensation in patients with ulcer-like functional dyspepsia is unclear and there are no guidelines for its treatment. Whilst much research and many pharmacological treatments have provided symptomatic relief of ulcer-like functional dyspepsia through control of acid secretion, the role of acid in ulcer-like functional dyspepsia is unknown. We carried out this study to investigate the role of hypersensitivity to acid in the sensation of pain in ulcer-like functional dyspepsia by direct administration of acid into stomach.

Methods: Twelve patients with ulcer-like functional dyspepsia (5 male, 7 female, mean age 41.0 years old, 7 with mild chronic superficial gastritis, 2 with metaplastic gastritis and 3 with normal endoscopic findings) and seven healthy control subjects (3 male, 4 female, mean age 36.0 years old, 7 with normal endoscopic findings) participated in the study. After overnight fasting, a nasogastric sump tube was inserted and its tip was positioned in the antrum under fluoroscopic guidance. Normal saline or 0.1N hydrochloric acid was administered in random and single blind cross over fashion. The test was considered positive only if similar pain developed-similar to that experienced by the patient under nonstudy condition- during the administration.

Results: Five patients (41.7%) developed pain with 0.1N hydrochloric acid administration, but none with normal saline (p < 0.05). None of the healthy controls developed pain upon administration of 0.1N hydrochloric acid or normal saline.

Conclusion: We suggest that acid hypersensitivity plays a role in the sensation of pain in ulcer-like functional dyspepsia.

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Related in: MedlinePlus

A. of 12 patients with ulcer-like functional dyspepsia, 5 patients developed pain during the acid infusion and no patient developed symptoms on saline infusion in a randomized single blind techniqueB. None of the control subjects showed positive response during acid or saline infusion in a randomized single blind technique(p<0.05).○; patient with ulcer-like functional dyspepsia who showed negative response during acid or saline infusion•; patient with ulcer-like functional dyspepsia who showed positive response during acid or saline infusion□; control subject who showed negative response during acid or saline infusion
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f1-kjim-12-2-188-10: A. of 12 patients with ulcer-like functional dyspepsia, 5 patients developed pain during the acid infusion and no patient developed symptoms on saline infusion in a randomized single blind techniqueB. None of the control subjects showed positive response during acid or saline infusion in a randomized single blind technique(p<0.05).○; patient with ulcer-like functional dyspepsia who showed negative response during acid or saline infusion•; patient with ulcer-like functional dyspepsia who showed positive response during acid or saline infusion□; control subject who showed negative response during acid or saline infusion

Mentions: Of 12 patients, 5 developed pain during the acid infusion that was similar to their usual pain in term of intensity or severity (41.7%) (Fig. 1). No patient experienced pain on saline infusion. Using Fishers exact test, this difference was statistically significant (p<0.05). Patients who showed positive response to acid infusion did not differ from those with negative reponse in terms of age, duration of disease or type and severity of symptoms. In patients who showed a positive response to acid infusion, the pain occurred within 5 minutes of starting the infusion.


Hypersensitivity to acid in ulcer-like functional dyspepsia.

Son HJ, Rhee PL, Kim JJ, Koh KC, Paik SW, Rhee JC - Korean J. Intern. Med. (1997)

A. of 12 patients with ulcer-like functional dyspepsia, 5 patients developed pain during the acid infusion and no patient developed symptoms on saline infusion in a randomized single blind techniqueB. None of the control subjects showed positive response during acid or saline infusion in a randomized single blind technique(p<0.05).○; patient with ulcer-like functional dyspepsia who showed negative response during acid or saline infusion•; patient with ulcer-like functional dyspepsia who showed positive response during acid or saline infusion□; control subject who showed negative response during acid or saline infusion
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4531982&req=5

f1-kjim-12-2-188-10: A. of 12 patients with ulcer-like functional dyspepsia, 5 patients developed pain during the acid infusion and no patient developed symptoms on saline infusion in a randomized single blind techniqueB. None of the control subjects showed positive response during acid or saline infusion in a randomized single blind technique(p<0.05).○; patient with ulcer-like functional dyspepsia who showed negative response during acid or saline infusion•; patient with ulcer-like functional dyspepsia who showed positive response during acid or saline infusion□; control subject who showed negative response during acid or saline infusion
Mentions: Of 12 patients, 5 developed pain during the acid infusion that was similar to their usual pain in term of intensity or severity (41.7%) (Fig. 1). No patient experienced pain on saline infusion. Using Fishers exact test, this difference was statistically significant (p<0.05). Patients who showed positive response to acid infusion did not differ from those with negative reponse in terms of age, duration of disease or type and severity of symptoms. In patients who showed a positive response to acid infusion, the pain occurred within 5 minutes of starting the infusion.

Bottom Line: Twelve patients with ulcer-like functional dyspepsia (5 male, 7 female, mean age 41.0 years old, 7 with mild chronic superficial gastritis, 2 with metaplastic gastritis and 3 with normal endoscopic findings) and seven healthy control subjects (3 male, 4 female, mean age 36.0 years old, 7 with normal endoscopic findings) participated in the study.After overnight fasting, a nasogastric sump tube was inserted and its tip was positioned in the antrum under fluoroscopic guidance.The test was considered positive only if similar pain developed-similar to that experienced by the patient under nonstudy condition- during the administration.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Sung Kyun Kwan University, Seoul, Korea.

ABSTRACT

Objectives: The mechanism of pain sensation in patients with ulcer-like functional dyspepsia is unclear and there are no guidelines for its treatment. Whilst much research and many pharmacological treatments have provided symptomatic relief of ulcer-like functional dyspepsia through control of acid secretion, the role of acid in ulcer-like functional dyspepsia is unknown. We carried out this study to investigate the role of hypersensitivity to acid in the sensation of pain in ulcer-like functional dyspepsia by direct administration of acid into stomach.

Methods: Twelve patients with ulcer-like functional dyspepsia (5 male, 7 female, mean age 41.0 years old, 7 with mild chronic superficial gastritis, 2 with metaplastic gastritis and 3 with normal endoscopic findings) and seven healthy control subjects (3 male, 4 female, mean age 36.0 years old, 7 with normal endoscopic findings) participated in the study. After overnight fasting, a nasogastric sump tube was inserted and its tip was positioned in the antrum under fluoroscopic guidance. Normal saline or 0.1N hydrochloric acid was administered in random and single blind cross over fashion. The test was considered positive only if similar pain developed-similar to that experienced by the patient under nonstudy condition- during the administration.

Results: Five patients (41.7%) developed pain with 0.1N hydrochloric acid administration, but none with normal saline (p < 0.05). None of the healthy controls developed pain upon administration of 0.1N hydrochloric acid or normal saline.

Conclusion: We suggest that acid hypersensitivity plays a role in the sensation of pain in ulcer-like functional dyspepsia.

Show MeSH
Related in: MedlinePlus