Gastric Activity and Gastrointestinal Peptides in Patients With Functional Dyspepsia
Condition: Dyspepsia
MeSH terms: Dyspepsia
Study type: Observational

Summary: 
      Rome III criteria defined functional dyspepsia (FD) as the presence of symptoms from the
      gastroduodenal region in the absence of any organic, systemic or metabolic disease that is
      likely to explain the symptoms. FD can be further subdivided into two diagnostic categories:
      postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).

      Disorders of gastric electric activity and abnormal gastric emptying are probably actively
      involved in the FD onset. Different noninvasive procedures may be applied in order to
      evaluate the gastric motor functions such as 13C breath testing and cutaneous
      electrogastrography. Besides, different gastrointestinal peptides (i.e. CCK, peptide YY,
      Neurotensin, Somatostatin, Leptin, Ghrelin, Motilin, Gastrin, Pepsinogen I and II) are
      involved in the control of gastroduodenal motility.

      Aims of the present study are: 1) to evaluate the GI peptide circulating concentrations, the
      gastric electrical activity and gastric emptying time by applying noninvasive procedures in
      patients suffering from functional dyspepsia and 2) to test whether a significant difference
      exists between the two diagnostic categories of meal-induced dyspeptic symptoms
    

Detailed description: 
      Functional dyspepsia is one of the most relevant functional gastrointestinal disorders
      (FGIDs) among general population. Rome III criteria defined functional dyspepsia as the
      presence of symptoms from the gastroduodenal region (early satiation, postprandial fullness,
      epigastric pain or burning) in the absence of any organic, systemic or metabolic disease that
      is likely to explain the symptoms. Etiological causes are still unclear, and the
      pathophysiological mechanisms still largely unknown. Besides, Helicobacter pylori infection
      is often present in these patients and contributes to complicate the clinical presentation.
      One of the main problem in the management of these patients is the lack of reliable
      biohumoral markers. Thus, functional disorders are usually diagnosed on the bases of
      symptomatic patterns. The Rome consensus has proposed to further subdivide FD into two
      diagnostic categories of meal-induced dyspeptic symptoms: postprandial distress syndrome
      (PDS), characterized by postprandial fullness and early satiation, and epigastric pain
      syndrome (EPS), characterized by epigastric pain and burning.

      Central processing of visceral stimuli, and its role in the pathogenesis of functional
      dyspepsia, as well as low-grade inflammation in the duodenum are important emerging topics in
      pathophysiology research. In this framework, disorders of gastric electric activity and
      abnormal gastric emptying are probably actively involved in the onset of symptomatology.
      Different noninvasive procedures may be applied in order to evaluate the gastric motor
      functions. Among them, gastric emptying time evaluation by 13C breath testing and cutaneous
      electrogastrography have raised attention for their reliability and potentiality. Another
      important pathophysiological concern of FD is represented by the possible alterations in
      circulating concentrations of different gastrointestinal peptides at various degree involved
      in the control of gastroduodenal motility [namely Cholecystokinin (CCK), peptide YY,
      Neurotensin, Somatostatin, Leptin, Ghrelin, Motilin, Gastrin, Pepsinogen I and II]. In
      previous studies significant lower levels of motilin was found in dyspeptic patients with
      altered antroduodenal motility was found. CCK mediates satiety by acting on the CCK receptors
      distributed widely throughout the central nervous system as well as effects on the vagus
      nerve. Other experimental data suggest that somatostatin and neurotensin may affect muscle
      contractility and delay the intestinal transit.

      On these bases aims of the study will be: 1) to evaluate the GI peptide circulating
      concentrations, the gastric electrical activity and gastric emptying time by applying
      noninvasive procedures in patients suffering from functional dyspepsia and 2) to test whether
      a significant difference exists between the two diagnostic categories of meal-induced
      dyspeptic symptoms
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients will be recruited in this observational study from the out-patients of the
        National Institute of Digestive Diseases, I.R.C.C.S. Saverio de Bellis, Castellana Grotte,
        Bari, Italy.
      
Biospecimen description: 
      breath specimen, whole blood, serum, white cells.
    
Keywords: Electrogastrography; Functional dyspepsia; Gastric emptying; Gastrointestinal peptides; Rome III criteria