Skip to main content
SpringerLink
Log in

Impaired gastric accommodation in patients with postprandial distress syndrome type of functional dyspepsia assessed by 2D ultrasonography

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background and Purpose

The pathophysiology of postprandial distress syndrome includes impaired gastric accommodation, hypersensitivity to gastric distension and delayed gastric emptying. 2D-ultrasonography is one of the methods to assess gastric accommodation by measuring proximal gastric area and we evaluated its role in calculating proximal gastric area and thus assessing gastric accommodation in Indian patients with postprandial distress syndrome.

Methods

In a hospital-based comparative analysis, proximal gastric area was measured with 2D-ultrasonography of postprandial distress syndrome (PDS) patients and compared with healthy controls. Five readings were measured every five minutes till 25 minutes after 400 mL of vegetable soup. The Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL score) and diets aggravating PDS symptoms were studied through detailed questionnaires. Sample size was calculated at 80% study power and alpha error of 0.05 to be 30 subjects in each group.

Results

The mean age of patients (18 males) vs. 30 healthy controls (25 males) was 40.8 ± 11.50 years vs. 36.37 ± 7.58, respectively, (p = 0.084). Proximal gastric area was significantly lower in patients versus healthy controls at five minutes (22.54 ± 2.77 vs. 30.66 ± 2.55 cm2), 10 minutes (23.03 ± 2.45 vs. 31.10 ± 2.06 cm2), 15 minutes (23.06 ± 2.27 vs. 30.31 ± 2.11 cm2), 20 minutes (22.21 ± 2.31 vs. 29.73 ± 1.71 cm2) and 25 minutes (22.02 ± 2.33 vs. 28.39 ± 1.55 cm2); p < 0.001 at all intervals of time, indicating impaired gastric accommodation. The QOL was poor in all patients with PDS with mean PAGI-QOL score of 31.30 ± 15.05, median of 30, minimum score of 12 and maximum score of 66.

Conclusions

Measurement of proximal gastric area with 2D-ultrasonography is simple and non-invasive. Proximal gastric area in patients was lower than controls, indicating impaired gastric accommodation. Poor quality of life was universal in patients with postprandial distress syndrome.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology. 2016;150:1380–92.

    Article  PubMed  Google Scholar 

  2. Tack J, Caenepeel P, Fischler B, Piessevaux H, Janssens J. Symptoms associated with hypersensitivity to gastric distention in functional dyspepsia. Gastroenterology. 2001;121:526–35.

    Article  CAS  PubMed  Google Scholar 

  3. Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J. Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology. 1998;115:1346–52.

    Article  CAS  PubMed  Google Scholar 

  4. Kindt S, Tack J. Impaired gastric accommodation and its role in dyspepsia. Gut. 2006;55:1685–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol. 2003;98:783–8.

    Article  PubMed  Google Scholar 

  6. Gilja OH, Hausken T, Odegaard S, Berstad A. Monitoring postprandial size of the proximal stomach by ultrasonography. J Ultrasound Med. 1995;14:81–9.

    Article  CAS  PubMed  Google Scholar 

  7. Fan XP, Wang L, Zhu Q, Ma T, Xia CX, Zhou YJ. Sonographic evaluation of proximal gastric accommodation in patients with functional dyspepsia. World J Gastroenterol. 2013;19:4774–80.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Undeland KA, Hausken T, Gilja OH, Aanderud S, Berstad A. Gastric meal accommodation studied by ultrasound in diabetes. Relation to vagal tone. Scand J Gastroenterol. 1998;33:236–41.

    Article  CAS  PubMed  Google Scholar 

  9. Tefera S, Gilja OH, Hatlebakk JG, Berstad A. Gastric accommodation studied by ultrasonography in patients with reflux esophagitis. Dig Dis Sci. 2001;46:618–25.

    Article  CAS  PubMed  Google Scholar 

  10. Olafsdottir E, Gilja OH, Aslaksen A, Berstad A, Fluge G. Impaired accommodation of the proximal stomach in children with recurrent abdominal pain. J Pediatr Gastroenterol Nutr. 2000;30:157–63.

    Article  CAS  PubMed  Google Scholar 

  11. Izbéki F, Kiss I, Wittmann T, Várkonyi TT, Légrády P, Lonovics J. Impaired accommodation of proximal stomach in patients with alcoholic liver cirrhosis. Scand J Gastroenterol. 2002;37:1403–10.

    Article  PubMed  Google Scholar 

  12. Mundt MW, Samsom M. Fundal dysaccommodation in functional dyspepsia: head-to-head comparison between the barostat and three-dimensional ultrasonographic technique. Gut. 2006;55:1725–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Goyal O, Goyal P, Kishore H, Kaur J, Kumar P, Sood A. Quality of life in Indian patients with functional dyspepsia: translation and validation of the Hindi version of Short-Form Nepean Dyspepsia Index. Indian J Gastroenterol. 2022;41:378–88.

    Article  PubMed  Google Scholar 

  14. Talley NJ, Locke GR, Lahr BD, et al. Functional dyspepsia, delayed gastric emptying, and impaired quality of life. Gut. 2006;55:933–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Aro P, Talley NJ, Agréus L, et al. Functional dyspepsia impairs quality of life in the adult population. Aliment Pharmacol Ther. 2011;33:1215–24.

    Article  CAS  PubMed  Google Scholar 

  16. Shaikh Z, Pathak R. Revised Kuppuswamy and B G Prasad. Socioeconomic scales for 2016. Int J Community Med Public Health. 2017;4:997–99.

  17. De La Loge C, Trudeau E, Marquis P, et al. Responsiveness and interpretation of a quality of life questionnaire specific to upper gastrointestinal disorders. Clin Gastroenterol Hepatol. 2004;2:778–86.

    Article  PubMed  Google Scholar 

  18. Gilja OH, Hausken T, Wilhelmsen I, Berstad A. Impaired accommodation of proximal stomach to a meal in functional dyspepsia. Dig Dis Sci. 1996;41:689–96.

    Article  CAS  PubMed  Google Scholar 

  19. Ghoshal UC, Paliwal M, Das K, Yachha SK, Sachdeva S, Misra A. Antroduodenal manometry: experience from a tertiary care center. Indian J Gastroenterol. 2008;27:53–7.

    PubMed  Google Scholar 

  20. Sachdeva S, Ghoshal UC, Saraswat VA, Das K, Misra A. Gastroduodenal dysmotility in patients with gallbladder carcinoma: frequency of occurrence and clinical importance. Natl Med J India. 2006;19:4–9.

    CAS  PubMed  Google Scholar 

  21. Ora M, Nazar AH, Parashar A, Kheruka S, Gambhir S. Gastric emptying scintigraphy: beyond numbers - an observational study to differentiate between various etiologies and a step toward personalized management. Indian J Nucl Med. 2019;34:194–200.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Anudeep V, Vinod KV, Pandit N, et al. Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus. Indian J Gastroenterol. 2016;35:385–92.

    Article  PubMed  Google Scholar 

  23. Somasundaram VH, Subramanyam P, Palaniswamy SS. A gluten-free vegan meal for gastric emptying scintigraphy: establishment of reference values and its utilization in the evaluation of diabetic gastroparesis. Clin Nucl Med. 2014;39:960–5.

    Article  PubMed  Google Scholar 

  24. Ajit N, Sachan A, Manthri RG, Mohan VK, Rallapeta RP, Kalawat T. Assessment of gastric dysmotility using standardized Tc-99m sulfur colloid-labeled rice cakes in diabetic patients. Indian J Nuclear Med 2022;37:359–66.

  25. Shava U, Srivastava A, Mathias A, Yaccha SK, Poddar U. Nutrient drink test: normative values in Indian children. Indian J Gastroenterol. 2017;36:405–10.

    Article  PubMed  Google Scholar 

  26. Sharma P, Makharia G, Yadav R, Dwivedi SN, Deepak KK. Gastric myoelectrical activity in patients with inflammatory bowel disease. J Smooth Muscle Res. 2015;51:50–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sethi S, Kar M, Patra S, et al. A study on gastric myoelectrical activity and inflammation [Internet]. 5th Annual Conference - Lucknow 2022.cdr. [cited 2022 Jan 5]. Available from: https://www.gimotilityindia.in/public/files/IMFDA_2022_souvenir_final_low_resolution.pdf.

  28. Sushmita CT, Shashikaran HC, Shetty S, Shetty P. The effect of Agnisara Kriya on gastric motility in students with obesity: a randomized controlled open trial. Int J Scientif Res. 2020;9:42–5.

    Google Scholar 

  29. Ghoshal UC, Singh R. Functional dyspepsia: the Indian scenario. J Assoc Physicians India. 2012;60 Suppl:6–8.

    PubMed  Google Scholar 

  30. Sud R, Pebbili KK, Desai SA, et al. Dyspepsia - The Indian perspective: a cross sectional study on demographics and treatment patterns of dyspepsia from across India (Power 1.0 study). J Assoc Physicians India. 2023;71:11–2.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Santokba Institute of Gastroenterology, Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, A-111, Shri Ram Marg, Shyam Nagar, Sodala, Jaipur, 302 019, India

    Ishtkhar Ahmed, Harsh Prasad Udawat, Sandeep Vaishnav, Dinesh Agrawal & Anurag Govil

  2. Department of Radiodiagnosis, Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Bhawani Singh Marg, Jaipur, 302 015, India

    Mohsin Ansari & Sunita Purohit

  3. Department of PSM, S M S Medical College, Jaipur, 302 004, India

    Rajeev Yadav

Authors
  1. Ishtkhar Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harsh Prasad Udawat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsin Ansari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rajeev Yadav
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sandeep Vaishnav
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dinesh Agrawal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anurag Govil
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sunita Purohit
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Concept: H. P. U., I. A., M. A.; design: H. P. U., I. A., R. Y.; supervision: A. G., D. A., S. P., S. V.; materials: H. P. U., S. V., D. A., A. G., S. P.; data collection and/or analysis: I. A., R. Y., M. A.; writing: H. P. U., I. A.; critical reviews: H. P. U., D. A., A. G., S. P., S. V.

Corresponding author

Correspondence to Harsh Prasad Udawat.

Ethics declarations

Conflict of interest

IA.HPU, MA, RY, SV, DA, AG and SP declare no competing interests.

Ethics approval and consent to participate

The study was performed conforming to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Ethical clearance was sought from the institutional ethics committee of Santokba Durlabhji Memorial Hospital cum Medical Research Institute, Jaipur with Ref. No. IEC/07/2017. All patients provided written consent prior to the entry into the study and performing 2D ultrasound measurement of proximal gastric area following a test meal.

Consent to publish

Patients signed informed consent regarding publishing their data.

Disclaimer

The authors are solely responsible for the data and contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ahmed, I., Udawat, H.P., Ansari, M. et al. Impaired gastric accommodation in patients with postprandial distress syndrome type of functional dyspepsia assessed by 2D ultrasonography. Indian J Gastroenterol 42, 824–832 (2023). https://doi.org/10.1007/s12664-023-01436-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-023-01436-7

Keywords

Search

Navigation