Volume 122, Issue 7, Pages 1738-1747 (June 2002) Clinical and pathophysiological characteristics of acute-onset functional dyspepsia  Jan Tack, Ingrid Demedts, Geert Dehondt, Philip Caenepeel, Benjamin Fischler, Michele Zandecki, Jozef Janssens  Gastroenterology  Volume 122, Issue 7, Pages 1738-1747 (June 2002) DOI: 10.1053/gast.2002.33663 Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 1 Prevalence of dyspeptic symptoms in patients with unspecified-onset functional dyspepsia (n = 302) compared with patients with presumed postinfectious functional dyspepsia (n = 66). The figure shows the percentage of patients grading individual symptoms as relevant or severe (score, ≥2) in each group. Early satiety, weight loss exceeding 5% of the initial body weight, nausea, and vomiting were significantly more prevalent in patients with presumed postinfectious functional dyspepsia. *P < 0.05. Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 2 Pathophysiologic abnormalities in patients with unspecified-onset functional dyspepsia compared with patients with presumed postinfectious functional dyspepsia. The figure shows the prevalence of H. pylori infection, delayed solid gastric emptying, hypersensitivity to gastric distention, and impaired accommodation to a meal for each group. The prevalence of impaired accommodation is significantly higher in patients with presumed postinfectious dyspepsia. H. pylori status and gastric emptying were studied in 302 patients with unspecified-onset functional dyspepsia and 66 patients with presumed postinfectious functional dyspepsia. Sensitivity to distention and accommodation were studied in 100 patients with unspecified-onset functional dyspepsia and 45 patients with presumed postinfectious functional dyspepsia. *P < 0.05. Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 3 Accommodation to a meal in 100 patients with unspecified-onset functional dyspepsia and 45 patients with presumed postinfectious functional dyspepsia. The figure shows the mean intragastric volume at 5-minute intervals as measured by a gastric barostat before and after administration of a mixed liquid meal (time = 0). Ingestion of the meal induced a rapid and sustained increase in intragastric volume, reflecting a relaxation of the gastric fundus. The meal-induced relaxation is significantly smaller in patients with presumed postinfectious dyspepsia. Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 4 (A) Gastric relaxation induced by administration of sumatriptan in the presence of placebo, 4 mg · kg−1 · h−1 L-NMMA, or 8 mg · kg−1 · h−1 L-NMMA. (B) Mean increase in the first 30 minutes after administration of sumatriptan with simultaneous administration of placebo, 4 mg · kg−1 · h−1 L-NMMA, or 8 mg · kg−1 · h−1 L-NMMA. L-NMMA significantly decreased the sumatriptan-induced gastric relaxation (*P < 0.05 compared with placebo). Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 5 Response to amyl nitrite inhalation in (A) 10 healthy controls, (B) 12 patients with unspecified-onset functional dyspepsia and impaired gastric accommodation to a meal, and (C) 11 patients with presumed postinfectious functional dyspepsia. The figure shows the mean intragastric volume at 1-minute intervals as measured by a gastric barostat before and after inhalation of 0.5 mL amylnitrite (time = 0). Inhalation of amyl nitrite induced a rapid and transient increase in intragastric volume, reflecting a relaxation of the gastric fundus. The amyl nitrite–induced relaxation is comparable in all groups. Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions

Fig. 6 Response to administration of sumatriptan in (A) 10 healthy controls, (B) 12 patients with unspecified-onset functional dyspepsia and impaired gastric accommodation to a meal, and (C) 11 patients with presumed postinfectious functional dyspepsia. The figure shows the mean intragastric volume at 5-minute intervals as measured by a gastric barostat before and after administration of 6 mg sumatriptan subcutaneously (time = 0). Administration of sumatriptan induced a rapid and sustained increase in intragastric volume, reflecting a relaxation of the gastric fundus in controls and patients with unspecified-onset functional dyspepsia. The sumatriptan-induced relaxation is significantly smaller in patients with presumed postinfectious functional dyspepsia. Gastroenterology 2002 122, 1738-1747DOI: (10.1053/gast.2002.33663) Copyright © 2002 American Gastroenterological Association Terms and Conditions