기능성 소화불량증과 역류성 식도염에서 위배출능 및 위 내 분포의 평가

Abstract

Background/Aims: Delayed gastric emptying and postprandial antral hypomotility are observed in patients with functional dyspepsia. These gastric motility abnormalities can be also associated with pathophysiology of reflux esophagitis. Thus, we studied intragastric food distribution and gastric emptying to examine food maldistribution in functional dyspepsia and reflux esophagitis. Methods: The patients with functional dyspepsia were categorized by prevalent discomfort patients (Group I, 10) and prevalent pain patients (Group II, 12). These two groups of patients ingested test meal labelled with technetium-99m. Patients with reflux esophagitis (Group IIl, 11) and healthy volunteers (Control, 2) ingested the same meal. Serial images of the gastric area were taken for 90 minutes and parameters of gastric emptying and intragastric distribution were examined for the regions of proximal, distal and total stomach. Results: Parameters of total gastric emptying (T1/2, retention at 30 min and 90 min, total gastric residence) in patients with functional dyspepsia and reflux esophagitis were not significantly different from those of controls. In the group II, all parameters of intragastric distribution were not different from those of controls. However, in the group I, initial activity (75.0%) in proximal gastric area after ingestion was significantly lower than that in controls (86.7%). Food distribution [maximal distal content (41.1%), distal gastric residence (41.1%)] in distal gastric area was significantly higher than that in controls [maximal distal content (28.5%), distal gastric residence (28.8%)]. In the Group III parameters of intragastric distribution are similar to those of the group I . Conclusions: Prevalent discomfort group of functional dyspepsia showed abnormal intragastric distribution of ingested food. On the other hand, they did not show delayed gastric emptying. The group of reflux esophagitis showed similar results.