Temporal and spatial relationship of pylorus to antroduodenal motility in functional dyspepsia.

OBJECTIVE

To investigate the temporal and spatial relationship of pylorus to antroduodenal motility in functional dyspepsia (FD).

METHODS

Eleven healthy subjects (HS) and 14 patients with FD were studied. Antral-pyloro-duodenal manometry was performed for 3 hours fasting and 2 hours after 80 Kcal of solid test meal.

RESULTS

(1) The incidence of phase III was 7/11 in HS and 3/14 in FD in antrum (P < 0.05), 8/11 and 4/14 in pylorus (P < 0.05), 10/11 and 6/14 in duodenum (P < 0.05), respectively. (2) The percentage of antropyloroduodenal coordinations during phase II of MMC was 58.5% in HS and 18.5% in FD (P < 0.001). (3) The pyloroduodenal coordination was 78.2% and 38.9% (P < 0.01) at 60 minutes after meal and 77.1% and 54.0% (P < 0.01) at 120 minutes postprandially in HS and in FD. (4) The percentage of isolated pyloric pressure waves (IPPWs) was 4.8%, 29.7% (P < 0.001) at 60 minutes, and 9.3%, 25.1% (P < 0.01) at 120 minutes in HS and FD.

CONCLUSIONS

There were abnormalities of gastro-pyloro-duodenal motility in both interdigestive and digestive stages; the higher incidence of IPPWs and disordered temporal and spatial relationship of pylorus to antroduodenal motility may result in a delayed gastric emptying in FD. The possible mechanism may be involved in abnormal neural control.