Symptom reporting by functional dyspeptics during the water load test

INTRODUCTION: Reporting of symptoms and visceral sensations in functional dyspepsia is subjective and influenced by such factors as somatization and depression. To better understand the role of these factors in symptom reporting, somatization, somatosensory amplification, alexithymia, and depression were evaluated in patients with functional dyspepsia undergoing a water load test. METHODS: Sixty-seven controls and 103 patients with functional dyspepsia underwent a 5-min water load. Participants both recalled dyspeptic symptoms from the previous 2 wk and rated symptoms of nausea, fullness, and bloating during water load. Participants also completed the symptom checklist-90-R, somatosensory amplification scale, and the Toronto alexithymia scale. RESULTS: Compared with controls, patients with dyspepsia had greater psychiatric distress and higher scores for somatosensory amplification and alexithymia. Patients with dyspepsia also reported fullness at significantly lower volumes of water and experienced greater symptoms during water load than controls. Receiver operator characteristics of water load volume and provoked symptoms suggested that water load (WL) volume was a better discriminator of patients with dyspepsia from controls. Patients with dyspepsia recalled significantly more symptoms in the 2 wk prior to study. Symptoms provoked during WL were not associated with measured psychiatric constructs in either controls or patients with dyspepsia whereas recalled symptoms in patients with functional dyspepsia were significantly associated with several measured psychiatric constructs. CONCLUSIONS: Patients with functional dyspepsia report fullness at lower volumes of ingested water and develop more symptoms than do controls. Water load volume better discriminates patients with dyspepsia from controls than does symptoms provoked during water load. Provoked symptoms in dyspepsia are not associated with measured psychiatric constructs but recalled symptoms are.