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Disturbed solid-phase gastric emptying in functional dyspepsia: a meta-analysis
Abstract
Functional dyspepsia is a common disorder with a diverse pathophysiological background, but the role of motility disorders in functional dyspepsia remains unclear. We aimed to quantify the relationship between disturbed gastric emptying and functional dyspepsia, using a meta-analytic approach. Through a structured literature search of Medline and Embase from 1983 to 1996, we selected all studies in which scintigraphic solid-phase gastric emptying was measured in both functional dyspeptic patients and controls. Seventeen studies involving 868 dyspeptic patients and 397 controls were pooled. Gastric emptying in patients with functional dyspepsia was 1.46 (1.23-1.69) times slower than controls; the proportion of patients with abnormally slow emptying was either 37% (34-40%, simple numeric pooling) or 39% (29-49%, weighted pooling). We conclude that gastric emptying of solids in patients with functional dyspepsia is 1.5 times slower than in healthy controls and that a significant delay of emptying is present in almost 40% of patients with functional dyspepsia.
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Altered GI motility and transit have long been recognized in the pathobiology of FGIDs such as IBS and functional dyspepsia.
“Altered GI motility and transit have long been recognized in the pathobiology of FGIDs such as IBS48 and functional dyspepsia (FD)49, 50.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [49]
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Self-citationWhy dyspepsia can occur without organic disease: pathogenesis and management of functional dyspepsia
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Prevalence of Gastric Motility Disorders in Patients with Functional Dyspepsia
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Gastric emptying of liquid and solid meals at various temperatures
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Mimidis, K., & Tack, J. F. (2008) · Digestive Diseases · doi:10.1159/000121346 · Cited by 49
“On the other hand, psychological factors, mainly anxiety, may also negatively affect the accommodation reflex [ , , , , , , , ,”
BackgroundReview: Evaluation and management of dyspepsia
Harmon, R. C., & Peura, D. A. (2010) · Therapeutic Advances in Gastroenterology · doi:10.1177/1756283x09356590 · Cited by 49
“…868 dyspeptic patients and 397 controls significant delay of solid gastric emptying was present in 30 40% of patients with functional dyspepsia [Quartero et al. 1998]; however, these findings did not correlate with patient symptoms [Jian et al. 1989; Talley et al. 1989; Wegener et al. 1989].”
ResultMaurer, A. H. (2012) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2011.10.001 · Cited by 47
“FD is now subdivided nto the following 2 diagnostic categories: (1) meal-induced yspeptic symptoms (postprandial distress syndrome), charcterized by postprandial fullness and early satiation, and (2) pigastric pain syndrome, characterized by epigastric pain nd burning.”
Preston, F. S., Bateman, S. C., Short, R. V., & Wilkinson, R. T. (1973) · PubMed · Cited by 44
Review article: the diagnosis and management of gastroparesis
Haans, J. J. L., & Masclee, A. (2007) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2007.03534.x · Cited by 41
Gastric sensitivity and reflexes: basic mechanisms underlying clinical problems
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Ford, A. C., Talley, N. J., Walker, M. M., & Jones, M. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12903 · Cited by 41
Role of vagus nerve in postprandial antropyloric coordination in conscious dogs
Ueno, T., Uemura, K., Harris, M. B., Pappas, T. N., & Takahashi, T. (2004) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00195.2004 · Cited by 39
“A significant delay of emptying was present in almost 40% of patients with FD (31).”
BackgroundKusunoki, H., Haruma, K., Hata, J., Kamada, T., Ishii, M., Yamashita, N., Inoue, K., Imamura, H., Manabe, N., & Shiotani, A. (2010) · Journal of Gastroenterology · doi:10.1007/s00535-010-0292-7 · Cited by 36
“Several pathophysiological causes of FD, such as delayed gastric emptying [2, 3 , 11, 21], abnormal antroduodenal motility [11, 34], altered sensitivity to duodenal acid or lipid exposure [35, 36], visceral hypersensitivity [37, 38], and an impaired accommodation reflex [6, 39] have been identified.”
BackgroundNoar, M. D., & Noar, E. (2008) · Surgical Endoscopy · doi:10.1007/s00464-008-9873-4 · Cited by 35
Gene polymorphisms associated with functional dyspepsia.
Kourikou, A., Karamanolis, G., Dimitriadis, G. D., & Triantafyllou, K. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i25.7672 · Cited by 31
Yagi, T., Asakawa, A., Ueda, H., Miyawaki, S., & Inui, A. (2013) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2013.1418 · Cited by 34
Jeon, Y.-J., Lee, J.-S., Cho, Y.-R., Lee, S.-B., Kim, W. Y., Roh, S., Joung, J., Lee, H. D., Moon, S.-O., Cho, J.-H., et al. (2019) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2019.111834 · Cited by 33
Türkkan, E., Uslan, M. İ., Acartürk, G., Topak, N., Kahraman, A., Dılek, F. H., Akcan, Y., Karaman, Ö., Çölbay, M., & Yüksel, Ş. (2009) · Journal of Gastroenterology · doi:10.1007/s00535-008-2271-9 · Cited by 33
Improvement of gastric motility by hemodialysis in patients with chronic renal failure
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“Several studies (Jian et al., 1989; Kerlin et al., 1989; Geldof et al., 1986; Stanghellini et al., 1996; Quartero et al., 1998; Tack et al., 1998) have addressed the role of gastric motility in generating dyspeptic symptom in some proportion of patients with functional dyspepsia (FD).”
Measuring Gastric Emptying: Comparison of 13C-Octanoic Acid Breath Test and Scintigraphy
Punkkinen, J., Konkka, I., Punkkinen, O., Korppi-Tommola, T., Färkkilä, M. A., & Koskenpato, J. (2006) · Digestive Diseases and Sciences · doi:10.1007/s10620-006-3122-2 · Cited by 31
“According to a meta-analysis of 17 scintigraphic studies, delayed gastric emptying is present in almost 40% of patients with functional dyspepsia (23).”
MethodShah, A., Kang, S., Talley, N. J., Do, A., Walker, M. M., Shanahan, E. R., Koloski, N. A., Jones, M., Keely, S., Morrison, M., et al. (2022) · Gut Microbes · doi:10.1080/19490976.2022.2132078 · Cited by 29
“Historically, it is believed that impaired gastric accommodation contributes to the manifestations of meal related (dyspeptic) symptoms(52) and that delayed gastric emptying plays a role in the pathophysiology of FGID.(53) Thus, the increased symptom response to the standardized nutrient challenge is not simply a refl…”
BackgroundInfluentialStanghellini, V., Tosetti, C., Horowitz, M., GIORGIO, R. D., Barbara, G., Cogliandro, R. F., Cogliandro, L., & Corinaldesi, R. (2003) · Digestive and Liver Disease · doi:10.1016/s1590-8658(03)00164-6 · Cited by 29
Association Between Symptoms, Quality of Life, and Gastric Emptying in Dyspeptic Patients
Wuestenberghs, F., Juge, M., Melchior, C., Desprez, C., Leroi, A., & Gourcerol, G. (2019) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm19060 · Cited by 28
Bennink, R. J., van den Elzen, B. D. J., Kuiken, S. D., & Boeckxstaens, G. E. (2004) · PubMed · Cited by 27
A 32-Year-Old Woman With Chronic Abdominal Pain
Lacy, B. E. (2008) · JAMA · doi:10.1001/jama.2007.51-a · Cited by 26
Pathophysiology of Functional Dyspepsia
Futagami, S., Shimpuku, M., Yin, Y., Shindo, T., Kodaka, Y., Nagoya, H., Nakazawa, S., Fujimoto, M., Izumi, N., Ohishi, N., et al. (2011) · Journal of Nippon Medical School · doi:10.1272/jnms.78.280 · Cited by 24
REVIEWS IN BASIC AND CLINICAL GASTROENTEROLOGY
Lynch, J. P., Metz, D. C., Schuppan, D., Junker, Y., & Barisani, D. (2009) · Cited by 24
Chiloiro, M., Russo, F., Riezzo, G., Leoci, C., Clemente, C., Messa, C., & Leo, A. D. (2001) · Digestive Diseases and Sciences · doi:10.1023/a:1005601623363 · Cited by 24
“Nevertheless, a recent meta-analysis (24) revealed that gastric emptying of a solid meal in those patients suffering from FD is approximately 1.”
BackgroundUse of salivary acetaminophen concentration to assess gastric emptying rate of liquids
Sanaka, M., Kuyama, Y., Nishinakagawa, S., & Mineshita, S. (2000) · Journal of Gastroenterology · doi:10.1007/s005350070087 · Cited by 24
Bloating in functional bowel disorders
Zar, S., Benson, M. J., & Kumar, D. (2002) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2002.01369.x · Cited by 25
Dyspepsia and Helicobacter pylori
Selgrad, M., Kandulski, A., & Malfertheiner, P. (2008) · Digestive Diseases · doi:10.1159/000121348 · Cited by 22
“Associated Factors Other than H. pylori A meta-analysis revealed that approximately 40p of the patients presenting with functional dyspepsia have delayed gastric emptying [”
BackgroundComparison of Clinical Features and Patient Background in Functional Dyspepsia and Peptic Ulcer
Nakao, H., Konishi, H., Mitsufuji, S., Yamauchi, J., Yasu, T., Taniguchi, J., Wakabayashi, N., Kataoka, K., & Okanoue, T. (2007) · Digestive Diseases and Sciences · doi:10.1007/s10620-006-9204-3 · Cited by 22
Helicobacter pylori and nonulcer dyspepsia
Talley, N. J., & Quan, C. (2002) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2002.0160s1058.x · Cited by 22
Talley, N. J. (2003) · Gastroenterology · doi:10.1016/j.gastro.2003.07.001 · Cited by 22
Functional dyspepsia: evaluation and treatment
Simrén, M., & Tack, J. F. (2003) · Gastroenterology Clinics of North America · doi:10.1016/s0889-8553(03)00023-2 · Cited by 21
Bouras, E. P., Roque, M. I. V., & Aranda‐Michel, J. (2013) · Nutrition in Clinical Practice · doi:10.1177/0884533613491982 · Cited by 21
Effects ofHelicobacter pyloriinfection on gastric emptying rate in patients with non-ulcer dyspepsia
Leontiadis, G. I. (2004) · World Journal of Gastroenterology · doi:10.3748/wjg.v10.i12.1750 · Cited by 21
“Helicobacter pylori (H pylori) infection and delayed gastric emptying have both been documented to have higher prevalence in patients with NUD compared with asymptomatic controls[3, 4 ]. However, it is unknown if H pylori infection and/or delayed gastric emptying are involved in the pathogenesis of NUD.”
BackgroundOverland, M. K. (2014) · Medical Clinics of North America · doi:10.1016/j.mcna.2014.01.007 · Cited by 20
Noddin, L., Callahan, M. J., & Lacy, B. E. (2005) · PubMed Central · Cited by 20
Metadata
- Authors
- Quarter, A. O., De Wit, N. J., Lodder, A. C., Numans, M. E., Smout, A. J. P. M., & Hoes, A. W.
- Affiliations
- Utrecht University (NL)
- Venue
- Digestive Diseases and Sciences
- Published
- 1998-09
- Volume
- 43
- Issue
- 9
- Pages
- 2028-2033
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- OpenAlex
- W70249653
- Cited by
- 209
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 7 · 2022: 3 · 2021: 7 · 2020: 10 · 2019: 7 · 2018: 4 · 2017: 6 · 2016: 7 · 2015: 4 · 2014: 6 · 2013: 11 · 2012: 11
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- Erasmus+
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- functional dyspepsia, gastric emptying, gastric motility disorders, gastric emptying scintigraphy, delayed gastric emptying
- MeSH terms
- Dyspepsia, Gastric Emptying, Gastrointestinal Motility, Humans
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