Abstract
There is no general agreement as regards the effect of Helicobacter pylori infection on gastric emptying in patients with functional dyspepsia. Food releases several gastrointestinal hormones, and some of these are known to contribute to the regulation of gastric emptying. The aim of this study was to investigate the influence of H. pylori on gastric emptying in dyspeptic and healthy subjects and to verify whether different hormone secretion patterns are affected by the presence of the bacterium. Twenty-seven patients affected by functional dyspepsia and 30 asymptomatic healthy subjects entered the study. H. pylori presence was assessed in controls by IgG antibodies to H. pylori and [13C] urea breath test, and that in patients by Warthin-Starry stain on gastric biopsies. After ingesting a standard solid-liquid meal, an ultrasound examination of gastric emptying was performed. Plasma concentrations of gastrin, cholecystokinin, and pancreatic polypeptide were measured in the fasting and postprandial period for 4 hours. The incidence of H. pylori infection was not higher in functional dyspepsia patients than in controls. As regards gastric emptying, no difference was detected between patients and controls with and without H. pylori infection. On the contrary, the presence of H. pylori infection determined alterations in gastrin levels, which were higher in controls than in patients. Basal CCK levels were higher in the H. pylori-negative patients than H. pylori-positive patients and controls. In conclusion, H. pylori infection seems not to cause alterations in gastric emptying, but rather alterations in gastrin levels. In contrast, the altered levels of CCK account for its involvement in the pathophysiology of H. pylori-negative dyspepsia.
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REFERENCES
Waldron B, Cullen PT, Kumar R, Smith D, Jankowski J, Hopwood D, Sutton D, Kennedy N, Campbell FC: Evidence for hypomotility in non-ulcer dyspepsia: A prospective multifactorial study. Gut 32:246–251, 1991.
Scott AM, Kellow JE, Shuter B, Cowan H, Corbett AM, Riley JW, Lunzer MR, Eckstein RP, Hoschl R, Lam SK: Intragastric distribution and gastric emptying of solids and liquids in functional dyspepsia. Lack of influence of symptom subgroups and H. pylori-associated gastritis. Dig Dis Sci 38:2247–2254, 1993
Fock KM, Khoo TK, Chia KS, Sim CS: Helicobacter pylori infection and gastric emptying of indigestible solids in patients with dysmotility-like dyspepsia. Scand J Gastroenterol 32:676–680, 1997
Chang CS, Chen GH, Kao CH, Wang SJ, Peng SN, Huang CK: The effect of Helicobacter pylori infection on gastric emptying of digestible and indigestible solids in patients with nonulcer dyspepsia. Am J Gastroenterol 91:474–479, 1996
Horowitz M, Dent J: Disordered gastric emptying: Mechanical basis, assessment and treatment. Baillieres Clin Gastroenterol 5:371–407, 1991
Christofides ND, Sarson DL, Albuquerque RH, Adrian TE, Ghatei MA, Modlin IM: Release of gastrointestinal hormones following an oral water load. Experentia 35: 1521–1522, 1979
Moss SF, Calam J: Acid secretion and sensitivity to gastrin in patient with duodenal ulcer: effect of eradication of Helicobacter pylori. Gut 34:888–892, 1993
Kaneko H, Mitsuma T, Uchida K, Furusawa A, Morise K: Immunoreactive somatostatin, substance P, and calcitonin gene-related peptide concentrations of the human gastric mucosa in patients with nonulcer dyspepsia and peptic ulcer disease. Am J Gastroenterol 88:898–904, 1993
Talley NJ, Colin-Jones D, Koch KL, Koch M, Nyrèn O, Stanghellini V: Functional dyspepsia: A classification with guidelines for management. Gastroenterol Int 4: 145–160, 1991
Thompson WG, Drossman DA, Heaton KW, Mazzacca G: Functional bowel disease and functional abdominal pain. Gastroenterol Int 5:75–91, 1992
Buckley MJ, Scanlon C, McGurgan P, O'Morain CA: A validated dyspepsia symptom score. Ital J Gastroenterol Hepatol 29:495–500, 1997
Correa P, Yardley JH: Grading and classification of chronic gastritis: one American response to the Sydney system. Gastroenterology 102:355–359, 1992
Hazell SL, Borody TJ, Gal A, Lee A: Campylobacter pyloridis gastritis I: Detection of urease as a marker of bacterial colonization and gastritis. Am J Gastroenterol 82: 292–296, 1987
Ricci R, Bontempo I, Corazziari E, La Bella A, Torsoli A: Real time ultrasonography of the gastric antrum. Gut 34:173–176, 1993
Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labò G: Measurement of gastric emptying time by real time ultrasonography. Gastroenterology 89:752–759, 1985
Bolondi L, Santi V, Bortolotti M, Li Bassi S, Turba E: Correlation between scintigraphic and ultrasonographic assessement of gastric emptying. Gastroenterology 90:1349, 1986
Buckley M, Morian CO. Prevalence of Helicobacter pylori in non-ulcer dyspepsia. Aliment Pharmacol Ther 9(suppl 2):53–58, 1995
Testoni PA, Bagnolo F, Masci E, Colombo E, Tittobello A: Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and without Helicobacter pylori infection. Dig Dis Sci 38:2255–2261, 1993
Fock KM, Khoo TK, Chia KS, Sim CS: Helicobacter pylori and gastric emptying of indigestible solids in patients with dysmotility-like dyspepsia. Scand J Gastroenterol 32:676–680, 1997
Barnett JL, Behler EM, Appelman AD, Elta GH: Campylobacter pylori is not associated with gastroparesis. Dig Dis Sci 34:1677–1680 1989
Testoni PA, Bagnolo F, Colombo E, Bonassi M, Tosi T: The correlation in dyspeptic patients of Helicobacter pylori infection with changes in interdigestive gastroduodenal motility patterns but not in gastric emptying. Helicobacter 1(4):229–237, 1996
Perri F, Clemente R, Festa V, Annese V, Quitidamo M, Rutgeerts and Andriulli A: Patterns of symptoms in functional dyspepsia. Role of Helicobacter pylori infection and delayed gastric emptying. Am J Gastroenterol 93:2082–2088, 1998
Waldron B, Cullen PT, Kumar R: Evidence for hypomotility in non-ulcer dyspepsia: A prospective multifactorial study. Gut 32:246–251, 1991
Quartero AO, De Wit NJ, Lodder AC, Numans ME, Smout AJPM, Hoes AW: Disturbed solid-phase gastric emptying in functional dyspepsia. A meta-analysis. Dig Dis Sci 43:2028–2033, 1998
Hovelius B, Andersson SI, Hagander B, Molstad S, Reimers P, Sperlich E, Wadstrom T: Dyspepsia in general practice: History and symptoms in relation to Helicobacter pylori serum antibodies. Scand J Gastroenterol 29:506–510, 1994
Trespi E, Broglia F, Villani L, Luinetti O, Fiocca R, Solcia E: Distinct profiles of gastritis in dyspepsia subgroups. Their different clinical responses to gastritis healing after Helicobacter pylori eradication. Scand J Gastroenterol 29:884–888, 1994
El-Omar E, Penman ID, Ardill JES, McColl KEL: A substantial proportion of non-ulcer dyspepsia patients have the same abnormality of acid secretion as duodenal ulcer patients. Gut 36:534–538, 1995
Katelaris PH, Seow F, Lin BPC, Napoli J, Ngu MC, Jones DB: Effect of age, Helicobacter pylori infection and gastritis with atrophy on serum gastrin and gastric acid secretion in healthy men. Gut 34:1032–1037, 1993
Wagener S, Haruma K, Gladziwa U, Soudah B, Gebel M, Bleck J, Schmidt H, Manns M. Helicobacter pylori infection and serum pepsinogen A, pepsinogen C, and gastrin in gastritis and peptic ulcer: Significance of inflammation and effect of bacterial eradication. Am J Gastroenterol 89:1211–1218, 1994
Tonge K, Forster E, Dockray G, Jacna MR: Aberrant cholecystokinin in response to a fat meal in non-ulcer dyspepsia. Digestion 1:757, 1998
Jonsson BH, Uvnõs-Moberg K, Theorell T, Gotthard R: Gastrin, cholecystokinin, and somatostatin in a laboratory experiment of patients with functional dyspepsia. Psychosom Med 60:331–337, 1998
Stacher G, Steinringer H, Schimierer G, Schneider C, Winklehner S: Cholecystokinin octapeptide decreases intake of solid food in man. Peptides 3:133, 1982
Cucchiara S, Devizia B, Chiloiro M: Anoressia e disturbi della motilità gastrointestinale. Prospet pediatr 22:305–312, 1992
Moran TH, McHugh PR: Cholecystokinin suppresses food intake by inhibiting gastric emptying. Am J Physiol 242:R491, 1982
Baile CA, McLaughlin CL, Delia-Fera MA: Role of cholecystokinin and opioid peptides in control of food intake. Physiol Rev 66:172, 1986
Schwartz TW: Pancreatic polypeptide: A hormone under vagal control. Gastroenterology 85:1411–1425, 1983
Tangen Haug T, Svebak S, Hausken T, Wilhelmsen I, Berstad A, Ursin H: Low vagal activity as mediating mechanism for the relationship between personality factors and gastric symptoms in functional dyspepsia. Psychosom Med 56:181–186, 1994
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Chiloiro, M., Russo, F., Riezzo, G. et al. Effect of Helicobacter pylori Infection on Gastric Emptying and Gastrointestinal Hormones in Dyspeptic and Healthy Subjects. Dig Dis Sci 46, 46–53 (2001). https://doi.org/10.1023/A:1005601623363
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DOI: https://doi.org/10.1023/A:1005601623363