New endoscopic method for gastric hypersensitivity testing: Pilot study

• Main Authors: Eri Momma, Mai Koeda, Tomohide Tanabe, Saori Kanai, Yoshimasa Hoshikawa, Shintaro Hoshino, Noriyuki Kawami, Mitsuru Kaise, Katsuhiko Iwakiri
• Format: Article
• Language: English
• Published: Wiley 2021-05-01
• Series: JGH Open
• Subjects: diagnostic test; dyspepsia; functional gastrointestinal disorder; hypersensitivity
• Online Access: https://doi.org/10.1002/jgh3.12544

Abstract Background and Aim Although one of the causes of dyspeptic symptoms in functional dyspepsia patients is gastric hypersensitivity, there is currently no routine endoscopic gastric hypersensitivity test. We developed a new endoscopic method for gastric hypersensitivity testing. The aim of the present study was to investigate whether this method is useful for evaluating gastric hypersensitivity in drug‐resistant functional dyspepsia patients who were strongly suspected of having gastric hypersensitivity. Methods Twenty‐seven drug‐resistant functional dyspepsia patients and 27 nonfunctional dyspepsia patients were recruited. Gastric pressure was assessed using an external pressure transducer, and the CO2 insufflation volume was measured using an endoscopic CO2‐supplied device and flow meter. The following variables were examined: gastric pressure at baseline and gastric pressure, the CO2 insufflation volume, and compliance of the stomach when patients initially felt abdominal tension following CO2 insufflation. Results No significant differences were observed in baseline gastric pressure or compliance of the stomach between the groups. Drug‐resistant functional dyspepsia patients had a significantly smaller CO2 insufflation volume and lower gastric pressure when symptoms developed than nonfunctional dyspepsia patients. Based on a cutoff value of 1.25 L by receiver operating characteristic curves, sensitivity and specificity for gastric pressure were 85.0 and 96.3%, respectively. Similarly, based on a cutoff value of 12.7 mmHg, sensitivity and specificity for the CO2 insufflation volume were 81.5 and 81.5%, respectively. Conclusion This endoscopic gastric hypersensitivity testing is a useful tool for evaluating the presence of gastric hypersensitivity.