Status about Tests for Pathogeneses in Functional Dyspepsia(Symposium : Frontiers Research and Practice in Psychosomatic Medicine)

Abstract

Functional dyspepsia is diagnosed in cases with chronic and recurrent epigastric fullness and/or pain with no evidence of organic diseases. The pathogeneses include gastrointestinal (GI) tract motolity disorder, GI tract hypersensitivity, psycho-social factors, and brain-gut interaction. Good relationship between patient and physician is essential in diagnosis and treatment, and explanation and assurance of the pathogeneses may affect the outcome. Radio-isotope and barostat device are required to evaluate GI tract function precisely, but it seems difficult to utilize these methods due to the drawback aspects of the special equipment, relatively high cost, and invasive nature at primary care setting. We have already reported that simaltanous measurement of gastric emptying and oro-cecal transit time is possible by ^<13>C-labelled octanoic acid and lactose ureide breath test and that total volume ingested of nutrient liquid to induce epigastric bloating may well reflect the accommodation volume by a barostat, suggesting that the breath test and nutrient drinking test should be an alterative easier way to gold standatd for examining the GI functions. Deviated activation of brain region in functional dyspepsia is getting to be detected by the progress of brain imaging technique. Devepment of tests for pathogeneses and groping for easy way have been performed.