Does interdigestive antro-duodenal motility pattern identify clinical sub-groups of dyspeptic patients? Review of 70 cases

Functional dyspepsia is characterized by various complaints occurring both in fasting and fed state. Recent reports have classified dyspeptic patients in clinical sub-groups according with symptom-based criteria and tried to correlate clinical aspects with gastric emptying disorders. No data are available about fasting motor pattern in these categories of dyspepsia. We studied 70 dyspeptic patients classified in four clinical sub-groups on the basis of predominant complaints: A) dysmotility-like (34 cases); B) ulcer-like (14 cases); C) reflux-like (9 cases); D) unspecified (13 cases). Eight healthy subjects acted as a control group. All the subjects underwent 240-min interdigestive antro-duodenal manometric recording. Every group of dyspeptic patients significantly differed (p <0.01) from control subjects in the incidence of overall and antral phase IIIs of the migrating motor complex (MMC), as well as in antral and duodenal phase-II motility index values. In all the dyspeptic patients, absence of an antral phase III of the migrating motor complex (MMC) in 240 minutes was the most frequent finding, with a statistically significant difference (p <0.02) in the incidence of antral phase III between ulcer-like and unspecified dyspepsia patients. No variations in all the groups of dyspeptic patients were observed in the durations of MMC and of its different phases nor in antral and duodenal phase-II motility index values. In conclusion, our data confirm the relation between functional dyspepsia and low incidence of antral phase III of MMC; in the ulcer-like sub-group, antral disorders seem to be less remarkable.