Association betweenH. pylori, duodenal mechanosensory thresholds, and small intestinal motility in chronic unexplained dyspepsia

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Abstract
Alterations of small intestinal sensory thresholds and small intestinal dysmotility are associated with functional dyspepsia. Because gastric and duodenal afferents partly project to the same areas, we postulated that patients with functional dyspepsia andH. pylori infection would be characterized by lower duodenal sensory thresholds. We evaluated 16 patients with functional dyspepsia and 16 age- and sex-matched controls. All patients had undergone an extensive diagnostic work-up to exclude organic lesions. Mechanosensitive function was tested in the third portion of duodenum utilizing a barostat device, and small intestinal motility was assessed before and during duodenal nutrient infusion with a five-channel low-compliance perfusion system.H. pylori status was assessed by a validated serological test. Small intestinal sensory thresholds (first perception and maximal tolerated pressure) were significantly lower in patients (21.1±2.1 and 30.9±1.8 mm Hg) compared to controls (33.0±2.2 and 38.8±0.9 mm Hg, allP0.3). However, in patients with defined highH. pylori titers (>50 units/ml) defineda priori, thresholds for first perception were significantly lower (14.7±2.9 mm Hg,N=5) compared to patients withH. pylori titers below this threshold (24.3±2.9 mm Hg,N=4) or withoutH. pylori infection (23.8±3.4 mm Hg,PPH. pylori-negative and -positive subjects. Sensory abnormalities are present in patients with functional dyspepsia. In a small subgroup of patients with highH. pylori titers, sensory abnormalities may be linked toH. pylori infection.

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