Background and Aim: Previous data show that psychological stress may alter gastric sensorymotor function. Neuro-hormonal mechanisms underlying this phenomenon in dyspeptic patients remain to be clarified. Aim of the present study is to assess autonomic nervous system activity and hypothalamic-pituitary-adrenal (HPA) axis hormones in response to mental stress before and after meal in dyspeptic patients. Subjects and methods: Fifteen patients with postprandial distress syndrome (PDS) (8 M, 21-40 years) and eight healthy controls (4 M, 19-28 years) underwent electrogastrography (EGG) and gastric emptying study (13C-octanoic acid breath test) using a 480 Kcal solid meal. Heart rate variability assessment (LF/HF ratio) by ECG and CRF, ACTH and cortisol on serum samples collected every 30 minutes for 5 hours were also evaluated. Dyspeptic symptoms (postprandial fullness and early satiety) were scored at same time points by analogue visual scale and expressed as sum of total symptoms scores (TSS). The study protocol, with and without a standardized mental stress (MS) test (serial numeric calculations for ten minutes) before the meal, was repeated in a random order in two different days. Results: Dyspeptic symptoms were present only in patients and were exclusively meal-related. In patients, but not in controls, MS significantly increased symptoms severity (TSS: 738±635 vs 288±301, p<0.05). LF/HF ratio was significantly higher in patients during postprandial period with than without MS (5.38±3.48 vs 2.78±0.92; p<0.05), whereas in controls it remained unmodified. In addition, a significant increase of ACTH postprandial levels after MS in patients (stress 6.63±3.11 pg/ml vs no-stress 3.72±2.07; p<0.05) was found, while in controls no modifications were observed. CRF and cortisol were unmodified both in patients and controls. Gastric emptying rate was delayed in 60 % of patients, but it was not influenced by MS. EGG did not show any modification. Conclusions: In PDS patients, concurrent administration of mental stress and meal increases symptoms severity by inducing enhanced sympathetic activity and increased HPA endocrine output. As the gastric emptying looks not altered, we can assume that these neuro-hormonal responses mainly affect gastric sensitive function

Mental Stress Increases Meal-Induced Symptoms Severity by Sympathetic Hyperactivity and Enhanced Endocrine Response in Patients With Postprandial Distress Syndrome / F., De Giorgi; Sarnelli, Giovanni; D., Viscardi; Ig, Savino; C., Cirillo; Cuomo, Rosario. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - ELETTRONICO. - 138:(2010), pp. S21-S22. [10.1016/S0016-5085(10)60099-6]

Mental Stress Increases Meal-Induced Symptoms Severity by Sympathetic Hyperactivity and Enhanced Endocrine Response in Patients With Postprandial Distress Syndrome

SARNELLI, GIOVANNI;CUOMO, ROSARIO
2010

Abstract

Background and Aim: Previous data show that psychological stress may alter gastric sensorymotor function. Neuro-hormonal mechanisms underlying this phenomenon in dyspeptic patients remain to be clarified. Aim of the present study is to assess autonomic nervous system activity and hypothalamic-pituitary-adrenal (HPA) axis hormones in response to mental stress before and after meal in dyspeptic patients. Subjects and methods: Fifteen patients with postprandial distress syndrome (PDS) (8 M, 21-40 years) and eight healthy controls (4 M, 19-28 years) underwent electrogastrography (EGG) and gastric emptying study (13C-octanoic acid breath test) using a 480 Kcal solid meal. Heart rate variability assessment (LF/HF ratio) by ECG and CRF, ACTH and cortisol on serum samples collected every 30 minutes for 5 hours were also evaluated. Dyspeptic symptoms (postprandial fullness and early satiety) were scored at same time points by analogue visual scale and expressed as sum of total symptoms scores (TSS). The study protocol, with and without a standardized mental stress (MS) test (serial numeric calculations for ten minutes) before the meal, was repeated in a random order in two different days. Results: Dyspeptic symptoms were present only in patients and were exclusively meal-related. In patients, but not in controls, MS significantly increased symptoms severity (TSS: 738±635 vs 288±301, p<0.05). LF/HF ratio was significantly higher in patients during postprandial period with than without MS (5.38±3.48 vs 2.78±0.92; p<0.05), whereas in controls it remained unmodified. In addition, a significant increase of ACTH postprandial levels after MS in patients (stress 6.63±3.11 pg/ml vs no-stress 3.72±2.07; p<0.05) was found, while in controls no modifications were observed. CRF and cortisol were unmodified both in patients and controls. Gastric emptying rate was delayed in 60 % of patients, but it was not influenced by MS. EGG did not show any modification. Conclusions: In PDS patients, concurrent administration of mental stress and meal increases symptoms severity by inducing enhanced sympathetic activity and increased HPA endocrine output. As the gastric emptying looks not altered, we can assume that these neuro-hormonal responses mainly affect gastric sensitive function
2010
Mental Stress Increases Meal-Induced Symptoms Severity by Sympathetic Hyperactivity and Enhanced Endocrine Response in Patients With Postprandial Distress Syndrome / F., De Giorgi; Sarnelli, Giovanni; D., Viscardi; Ig, Savino; C., Cirillo; Cuomo, Rosario. - In: GASTROENTEROLOGY. - ISSN 0016-5085. - ELETTRONICO. - 138:(2010), pp. S21-S22. [10.1016/S0016-5085(10)60099-6]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/491495
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