Patients with functional dyspepsia have reduced fasting radial strain of the gastric antrum

Introduction: Antral dysmotility has been shown to be present in patients with functional dyspepsia (FD) by using manometry. Strain rate imaging (SRI) is a non-invasive ultrasound modality that enables detailed analysis of antral contraction.

Aims: To evaluate antral strain in patients with FD compared to healthy controls (HC), fasting and postprandially and to assess gastric accommodation, gastric emptying and symptom profiles in FD and HC.

Materials and methods: In 12 patients with FD and 12 healthy controls (HC), fasting and postprandial antral contractions were analysed using SRI. Gastric accommodation and gastric emptying were assessed using 2D ultrasonography.

Results & discussion: In the fasting state, anterior antral radial strain was lower in FD patients than in HC (46.88% vs. 29.61%, p<0.01). There was no difference in postprandial strain. Fasting, FD patients had larger proximal area of the stomach than HC (13.47cm² vs. 7.90cm², p<0.01) and higher symptom scores for pain, fullness, satiation and total discomfort (p<0.05). Antral CSA tended to be larger in FD than in HC (4.13cm² vs. 2.24cm², p=0.09). At one min postprandially, the proximal stomach in FD was smaller than in HC (24.58cm² vs. 28.77cm², p<0.05), indicating impaired accommodation. While there was no difference at 10min, at both 20 and 40min the proximal area of the stomach was larger in FD than HC (20.1cm² vs. 15.6cm², p<0.05 and 17.0 vs. 10.4, p<0.001, respectively), indicating reduced gastric emptying.