Relationship Between Partial Gastric Volumes and Dyspeptic Symptoms in Fundoplication Patients: A 3D Ultrasonographic Study

Scheffer, R. C. H.; Gooszen, H. G.; Wassenaar, E. B.; Samsom, M.
October 2004
American Journal of Gastroenterology;Oct2004, Vol. 99 Issue 10, p1902
Academic Journal
OBJECTIVES: Impaired gastric accommodation may induce dyspeptic symptoms in postfundoplication patients. Our aim was to assess the effect of a meal on total and partial gastric volumes in relation to dyspeptic symptoms in both dyspeptic and nondyspeptic fundoplication patients using three-dimensional (3D) ultrasonography.METHODS: Eighteen postfundoplication patients of whom eight with and ten without dyspeptic symptoms and eighteen controls were studied. Three-dimensional ultrasonographic images of the stomach were acquired and symptoms were scored while fasting and at 5, 15, 30, 45, and 60 min after ingesting of a 500-ml liquid meal. From the 3D ultrasonographic images of the stomach the total, proximal, and distal gastric volumes were computed.RESULTS: Dyspeptic and nondyspeptic fundoplication patients exhibited similar total gastric volumes at 5 min postprandially compared to controls, whereas smaller total gastric volumes were observed from 15 to 60 min postprandially (p= 0.007 andp<0.001, respectively). Postprandial proximal/total gastric volume ratios were markedly reduced in both dyspeptic (0.39± 0.016;p<0.05) and nondyspeptic (0.38± 0.016;p<0.01) fundoplication patients compared to controls (0.47± 0.008). In contrast, distal/total gastric volume ratios were larger in dyspeptic fundoplication patients (0.14± 0.008) compared to both nondyspeptic fundoplication patients (0.11± 0.007);p<0.05) and controls (0.07± 0.003);p<0.001). Dyspeptic fundoplication patients had a higher postprandial score for fullness, nausea, and pain than nondyspeptic patients (p<0.05) and controls (p<0.05). Meal-induced distal gastric volume increase correlated significantly with the increase in fullness (r= 0.68;p<0.01).CONCLUSIONS: After a liquid meal, fundoplication patients exhibit a larger volume of the distal stomach compared with controls. Distal stomach volume was more pronounced in dyspeptic fundoplication patients and related with the increase in postprandial fullness sensations.(Am J Gastroenterol 2004;99:1-8)


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