Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2016; 22(18): 4585-4593
Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4585
Changes in patients’ symptoms and gastric emptying after Helicobacter pylori treatment
Chun-Ling Zhang, Chang-Hui Geng, Zhi-Wei Yang, Yan-Lin Li, Li-Quan Tong, Ping Gao, Yue-Qiu Gao
Chun-Ling Zhang, Zhi-Wei Yang, Department of Ultrasound, Daqing Oilfield General Hospital, Daqing 163001, Heilongjiang Province, China
Chang-Hui Geng, Yan-Lin Li, Li-Quan Tong, Department of General Surgery, the Fifth Affiliated Hospital of Harbin Medical University, Harbin 163316, Heilongjiang Province, China
Ping Gao, Department of Gastroenterology, Daqing Oil Field General Hospital, Daqing 163001, Heilongjiang Province, China
Yue-Qiu Gao, Department of Gastroenterology, Harbin Medical University Affiliated Fifth Hospital, Harbin 163316, Heilongjiang Province, China
Author contributions: Zhang CL and Geng CH contributed equally to this work; Zhang CL, Geng CH and Yang ZW designed the research; Zhang CL, Geng CH, Li YL, Tong LQ, Gao P and Gao YQ performed the research; Yang ZW, Tong LQ, Gao P and Gao YQ contributed new reagents/analytic tools; Zhang CL and Geng CH analyzed the data; Zhang CL and Geng CH wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Daqing oilfield general hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that no conflict of interests in our study is going to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chang-Hui Geng, Deputy Chief Physician, Gastroenterological Surgery, Clinical and Basic Research of Colorectal Cancer, Department of General Surgery, the Fifth Affiliated Hospital of Harbin Medical University, No. 213 Jianshe Road, Sartu District, Harbin 163316, Heilongjiang Province, China. gengchanghui@163.com
Telephone: +86-459-6612610 Fax: +86-459-6612610
Received: January 24, 2016
Peer-review started: January 25, 2016
First decision: February 18, 2016
Revised: February 29, 2016
Accepted: March 18, 2016
Article in press: March 18, 2016
Published online: May 14, 2016
Processing time: 100 Days and 13.7 Hours
Abstract

AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia (FD) patients.

METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori (H. pylori)-negative group (28 patients), and H. pylori-positive group (42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group (21 patients) and conventional treatment group (21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were given conventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups.

RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group (50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the control group (93.7 ± 26.2 vs 72.0 ± 14.3; 102.2 ± 26.4 vs 87.5 ± 18.2; 102.1 ± 28.6 vs 78.3 ± 14.1; all P < 0.05). Abdominal distension, belching and early satiety had an effect on distal gastric half-emptying time (P < 0.05). Abdominal distension and abdominal pain had an effect on the gastric half-emptying time of the whole stomach (P < 0.05). All were risk factors (odds ratio > 1). The total symptom score of the 3 groups after treatment was lower than before treatment (P < 0.05). Total symptom scores after treatment in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group (5.15 ± 2.27 vs 7.02 ± 3.04, 4.93 ± 3.22 vs 7.02 ± 3.04, All P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the H. pylori-negative and H. pylori-treatment groups were shorter than in the conventional treatment group (P < 0.05).

CONCLUSION: FD patients have delayed gastric emptying. H. pylori infection treatment helps to improve symptoms of dyspepsia and is a reasonable choice for treatment in clinical practice.

Keywords: Functional dyspepsia; Gastric emptying; Ultrasound

Core tip: Stomach half-emptying time was determined in Helicobacter pylori (H. pylori) patients and healthy controls. The half-emptying times at the proximal end, distal end, and the whole stomach in the functional dyspepsia (FD) group were slower than in the control group. Total symptom scores in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group after treatment. Patients with FD have delayed gastric emptying. Treatment of H. pylori infection helps to improve symptoms of dyspepsia and is a reasonable choice for therapy in clinical practice.