Interpretation of Bloating Feeling and Epigastric Pain : with a View of Gastric Function(Symposium/Brain-gut Interaction in the Pathophysiology of Functional Dyspepsia)

Abstract

Gastric physiological dysfunction such as hypersensitiyity and motility disorder play an important role in pathogenesis of functional dyspepsia. However, the mechanisms inducing bloating feeling and epigastric pain remain unclear, since the relationship between pathophisiology and symptom has not been discussed enough. Our investigation using both the barostat method as a gold standard and the drinking test as an easy method, clarified an accomplishment of gastric accommodation induced postprandial bloating feeling. It was also elucidated that a gastric acid secretion inhibitor improved dyspeptic symptom by increasing the gastric perception threshold against intragastric distention, and prokinetic drugs did by increasing the threshold volume inducing bloating feeling. The drinking test is expected as a clinical useful tool for exploring gastric perception and motor function, though there are several problems including standardization of methodology to be solved. Because this method might have a potency to investigate the effects of various stressors upon gastric function, objective analyses on the relationship between psychosocial factors and dyspeptic symptoms would be expected.