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Type: Journal article
Title: Functional dyspepsia is associated with a greater symptomatic response to fat but not carbohydrate, increased fasting and postprandial CCK, and diminished PYY
Author: Pilichiewicz, A.
Feltrin, K.
Horowitz, M.
Holtmann, G.
Wishart, J.
Jones, K.
Talley, N.
Feinle-Bisset, C.
Citation: American Journal of Gastroenterology, 2008; 103(10):2613-2623
Publisher: Blackwell Publishing Ltd
Issue Date: 2008
ISSN: 0002-9270
Statement of
Amelia N Pilichiewicz, Kate L. Feltrin, Michael Horowitz, Gerald Holtmann, Judith M. Wishart, Karen L. Jones, Nicholas J. Talley and Christine Feinle-Bisset
Abstract: BACKGROUND/OBJECTIVES: In patients with functional dyspepsia (FD), symptoms are frequently triggered, or exacerbated, by fatty foods. We hypothesized that in FD patients, a high-fat (high-FAT) meal would induce more symptoms than a high-carbohydrate (high-CHO) meal, associated with an altered secretion of cholecystokinin (CCK), peptide-YY (PYY), and ghrelin and an increased antral size, when compared to healthy subjects (HS). METHODS: FD symptoms, appetite perceptions, plasma hormones, and antral area were measured in 8 FD patients and 8 HS on three separate days after the ingestion of high-CHO or high-FAT (500 kcal/400 g) meals, or a low-nutrient control (180 kcal/400 g); the energy intake was quantified 60 min later. RESULTS: Nausea (P < 0.01) and pain (P= 0.05) were greater in FD after the high-FAT, when compared to high-CHO and control meals and in HS. Discomfort was greater after all meals in FD when compared to HS (P < 0.05). Fasting CCK and stimulation of CCK by the high-FAT (P < 0.01) meal were greater in FD, while fasting and postprandial PYY were lower (P < 0.001) in FD than in HS, with no differences in fasting, or postprandial, plasma ghrelin between FD and HS. Fasting antral area was greater in FD (P < 0.05), with no differences postprandially between FD and HS. There were no differences in the energy intake between the two groups. CONCLUSIONS: In FD patients: (a) a high-FAT meal induces more symptoms than an isocaloric high-CHO meal, and (b) fasting and postprandial plasma CCK concentrations are greater and PYY concentrations are less. Our findings have important implications for the development of diet-based therapies for the treatment of FD.
Keywords: Humans; Disease Progression; Dyspepsia; Cholecystokinin; Peptide YY; Dietary Carbohydrates; Dietary Fats; Prognosis; Fasting; Questionnaires; Follow-Up Studies; Postprandial Period; Adult; Middle Aged; Female
Rights: © 2009 The American College of Gastroenterology
RMID: 0020083343
DOI: 10.1111/j.1572-0241.2008.02041.x
Appears in Collections:Medicine publications

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