Symptomatic, radionuclide and therapeutic assessment of chronic idiopathic dyspepsia
- 44 Downloads
Twenty-eight patients with chronic idiopathic dyspepsia defined by the presence of chronic unexplained symptoms suggestive of gastric stasis and directly related to food ingestion were included in this prospective study. Gastric emptying of the liquid and solid phases of a meal was quantified by a dual-isotope method, and symptoms were evaluated by a diary and a visual analog scale. Delay in gastric emptying was evidenced in 59% of the dyspeptic patients; it occurred with liquids in more cases than solids. Quantitative and qualitative evaluation of symptoms was of no practical value in predicting the presence of objective stasis. The dyspeptic patients were included in a double- blind randomized controlled trial of cisapride, a new gastrokinetic drug devoid of central antiemetic effects. After six weeks of cisapride treatment, all patients with initially abnormal gastric emptying rates for liquids, and all but one for solids returned to normal ranges, and significant differences between cisapride and placebo groups were observed for half emptying times of both solids (136±16 min vs 227 ±32 min; P<0.02) and liquids (61±4 min vs 132±37 min; P<0.01). Cisapride also significantly improved dyspeptic symptom scores at weeks 3 and 6 of treatment as compared to those measured before treatment. Nevertheless, the decrease in global diary score was significantly higher than that seen with placebo at week 3 (−16±6 vs −1±9; P<0.05), but not at week 6 (−18±5 vs −10±8). The symptomatic effect of cisapride at week 3 was significantly more pronounced in patients with abnormal initial gastric emptying than in those with normal gastric emptying (−30±7vs −4±6; P<0.02).These results underline the importance of objective evaluation of gastric emptying in the detection of patients with gastric stasis who exhibited the best symptomatic response to cisapride.
Key wordsgastric emptying radioisotopes gastroparesis dyspepsia gastrokinetics cisapride
Unable to display preview. Download preview PDF.
- 4.Reyntjens A, Verlinden M, Schuurkes J, Van Nueten J, Janssen PA: New approach to gastrointestinal motor dysfunction: non-antidopaminergic, non-cholinergic stimulation with cisapride. An introductory survey. Curr Ther Res 36:1063–1070, 1984Google Scholar
- 9.Reedy TJ, Elashoff JD: Direct fitting of simple and power exponential curves to gastric emptying data. Cure Technical Report 1982Google Scholar
- 10.Hamilton M: Diagnosis and rating of anxiety. Br J Psychiatr special publication No. 3: 76–79, 1969Google Scholar
- 12.Bolondi L, Bortolotti M, Santi V, Galetti T, Gaiani S, Labo G: Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology 89:752–759, 1985Google Scholar
- 13.Cottrell CR, Sninsky CA, Martin JL, Mathias JR: Are alterations in gastroduodenal motility responsible for previously unexplained nausea vomiting and abdominal pain? Dig Dis Sci 27:650, 1982 (abstract)Google Scholar
- 14.Raiti C, Corinaldesi R, Stanghellini V, Gacomoni E, Rea E, Paterico A, Barbara L: Gastric acid secretion and gastric emptying time in patients with functional dyspepsia. Ital J Gastroenterol 17:173, 1985 (abstract)Google Scholar