Sensitivity to nutrients in patients with non-ulcer dyspepsia

Objective: To test the hypothesis that a cohort of patients with non-ulcer dyspepsia may have gastroduodenal receptors that are abnormally sensitive to nutrients. Design: Gastric emptying of high and low fat liquid test meals was compared with postprandial symptoms in 31 patients with non-ulcer dyspepsia (nine men, 22 women, aged 17–64 years) and in 17 healthy controls (nine men, eight women, aged 20–58 years). Methods: Gastric emptying was measured scintigraphically using the lateral image γ-camera technique. Results: Twenty-one patients had normal gastric emptying. Of the remainder, six female patients showed abnormally delayed emptying of the fatty soup but normal emptying of the bland soup, three others showed delayed emptying of both soups while one male patient showed initial rapid emptying of the fatty soup followed by a period of minimal emptying. While symptom scores were higher in patients than in controls and greater following the fatty soup than the bland soup, there were minimal differences in either the occurrence of symptoms or symptom presentation between patients with normal and those with abnormal gastric emptying and none between patients with different emptying patterns. However, female patients complained of more dyspeptic symptoms during the tests and all those who showed delayed emptying patterns were female. Conclusions: This study suggests that gastric emptying of either bland or fatty liquids is normal in the majority of patients with non-ulcer dyspepsia; postprandial symptom scores and dyspeptic symptoms are not correlated with disturbances in gastric emptying, and a high proportion of patients with non-ulcer dyspepsia can be characterized by an increased gastroduodenal sensitivity to meals of high energy or lipid content which may be associated with delayed emptying of such test meals.