TY - JOUR
T1 - Clinical classification of subgroups according to the rome III criteria cannot be used to distinguish the associated respective pathophysiology in Japanese patients with functional dyspepsia
AU - Ochi, Masahiro
AU - Tominaga, Kazunari
AU - Tanaka, Fumio
AU - Tanigawa, Tetsuya
AU - Yamagami, Hirokazu
AU - Watanabe, Kenji
AU - Watanabe, Toshio
AU - Fujiwara, Yasuhiro
AU - Arakawa, Tetsuo
PY - 2013
Y1 - 2013
N2 - Objective Patients who meet the Rome III criteria for functional dyspepsia (FD) are generally classified into the following two subgroups, those with postprandial distress syndrome (PDS) and those with epigastric pain syndrome (EPS), in order to treat the dyspeptic symptoms caused by the respective pathophysiological conditions. However, whether simple classification of FD can accurately distinguish the pathophysiological differences between PDS and EPS remains to be clarified because the pathophysiology of FD is characterized and complicated by various factors. Methods After classifying FD patients who were not receiving medication at the initial visit, we assessed and compared the following pathophysiological factors between the PDS and EPS groups: (1) the gastric reservoir and emptying functions using a radioisotope method (n=75), (2) the autonomic nervous system (ANS) function using electrocardiography (n=45), (3) gastric mucosal atrophy and intestinal metaplasia using histological examinations (n=47), (4) endoscopic findings of the stomach, such as superficial changes, abnormal gastroesophageal flap valves (n=67) and (5) Helicobacter pylori infection (n=48). Results The FD patients exhibited higher rates of an impaired reservoir function (49.3%), gastric emptying disorders (54.7%) and relative hyperactivity of the sympathetic nervous system (31.9%) than the control subjects. However, endoscopic and histological changes of the stomach were similar in both the FD patients and control subjects. In addition, no differences were observed in the above-mentioned factors between the PDS and EPS groups. Conclusion The simple classification of FD patients into two subgroups according to the Rome III criteria following diagnosis does not indicate any differences in the pathophysiology related to the respective dyspeptic symptoms of FD patients.
AB - Objective Patients who meet the Rome III criteria for functional dyspepsia (FD) are generally classified into the following two subgroups, those with postprandial distress syndrome (PDS) and those with epigastric pain syndrome (EPS), in order to treat the dyspeptic symptoms caused by the respective pathophysiological conditions. However, whether simple classification of FD can accurately distinguish the pathophysiological differences between PDS and EPS remains to be clarified because the pathophysiology of FD is characterized and complicated by various factors. Methods After classifying FD patients who were not receiving medication at the initial visit, we assessed and compared the following pathophysiological factors between the PDS and EPS groups: (1) the gastric reservoir and emptying functions using a radioisotope method (n=75), (2) the autonomic nervous system (ANS) function using electrocardiography (n=45), (3) gastric mucosal atrophy and intestinal metaplasia using histological examinations (n=47), (4) endoscopic findings of the stomach, such as superficial changes, abnormal gastroesophageal flap valves (n=67) and (5) Helicobacter pylori infection (n=48). Results The FD patients exhibited higher rates of an impaired reservoir function (49.3%), gastric emptying disorders (54.7%) and relative hyperactivity of the sympathetic nervous system (31.9%) than the control subjects. However, endoscopic and histological changes of the stomach were similar in both the FD patients and control subjects. In addition, no differences were observed in the above-mentioned factors between the PDS and EPS groups. Conclusion The simple classification of FD patients into two subgroups according to the Rome III criteria following diagnosis does not indicate any differences in the pathophysiology related to the respective dyspeptic symptoms of FD patients.
KW - Autonomic nervous system
KW - Epigastric pain syndrome
KW - Gastric motility
KW - H. pylori
KW - Postprandial distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=84878960558&partnerID=8YFLogxK
U2 - 10.2169/internalmedicine.52.9205
DO - 10.2169/internalmedicine.52.9205
M3 - 学術論文
C2 - 23774536
AN - SCOPUS:84878960558
SN - 0918-2918
VL - 52
SP - 1289
EP - 1293
JO - Internal Medicine
JF - Internal Medicine
IS - 12
ER -