Gastric Motor Functions in Patients with Mood Disorders and Functional Gastroduodenal Symptoms

Objective Functional gastroduodenal symptoms (FGDSs) may result from perturbations in gastric emptying (GE) and gastric accommodation (GA), which are variably affected by acute stress. This study aimed to examine whether individuals who have both mood disorder and FGDS exhibit differences in GE and GA using standardized, validated, and reproducible noninvasive methods. Methods Using a data retrieval program, 1554 individuals at a single center were identified after having undergone measurements of GE by scintigraphy of a 99mTc-radiolabeled egg (320 kcal, 30% fat meal) and GA by single-photon emission computed tomography to assess the underlying pathophysiology in FGDS. An extensive medical record review identified 267 of these individuals as having diagnoses of depression, anxiety, or comorbid anxiety/depression (CAD). Differences in GE and GA as related to the presence of anxiety or depressive disorders were analyzed using one-way analysis of variance on ranks and Mann-Whitney tests for the two-group comparisons. Results Sixty-Three patients with anxiety, 134 with depression, and 70 with CAD were identified. GE at 1 hour was slower (p =.04) and GE at 2 hours numerically decreased (p =.07) for depression compared with anxiety. GA was diminished for CAD compared with anxiety (p =.04) and depression (p =.009). There were no differences in fasting gastric volume or GE at 4 hours. Conclusions In this study examining GE and GA in anxiety and depressive disorders among patients with FGDS, the combined presence of anxiety and depression was associated with impaired GA compared with patients with depression or anxiety alone, and early GE seemed to be slower in those with depression compared with patients with anxiety.