Objective To investigate clinical characters of functional dyspepsia (FD) and organic dyspepsia (OD) and evaluate the Chinese management guideline of dyspepsia. Methods Three hundreds patients with epigastric dyspepsia symptoms received a series of examinations including a detailed investigation of symptoms, liver functions, upper gastrointestinal endoscopy and B ultrasound, and then they were divided into OD and FD groups in accordance with Rome Ⅱ criteria. Results 153 (51.0%) and 147 cases (49.0%) were ascribed to FD and OD respectively. FD occurred more often at the age of less than 40 ( P =0.006). The scores of such symptoms as bloating( P

Disorders of gastrointestinal motility are common complications in patients with diabetes mellitus and may involve the whole alimentary tract. Dyspepsia, gastroparesis and constipation are very common. Gastric dysfunction in diabetes may influence the pharmocokinetics of hypoglycemic and other drugs. This article reviews the disorders of gastrointestinal motility in diabetes and possible mechanisms.

Current concerns for the diagnosis of functional gastrointestinal disorders (FGIDs) in clinical practice is reviewed in this paper.They include the principle to exclude the organic diseases,a full recognition of subtype classification and the severity degrees in guiding the treatment,role of gastrointestinal function examination in diagnosis and treatment,influence of psychological factors on disease,and the overlapping phenomenon of functional disease with organic diseases.

ObjectiveTo compare the difference effects on the proximal stomach in rapid(intake rate 100 mL/min) and slow(intake rate 15 mL/min) LNLT.Methods Forty healthy subjects received both the rapid and slow LNLTs.The caloric density of the nutrient was 1 kcal/mL. The TVDRI and MVDRI were recorded,and the corresponding TVPS and MVPS were measured by B-ultrasound.Results(1) There were positive correlation was identified between TVDRI and TVPS,and between MVDRI and MVPS in both slow and rapid LNLTs.(2) TVDRI and MVPS in slow LNLT were significantly smaller than those in rapid LNLT,but MVDRI was significantly larger in slow LNLT than that in rapid LNLT.(3) TVDRI was much closer to TVPS in slow LNLT than those in rapid LNLT.But MVDRI was much closer to MVPS in rapid LNLT than those in slow LNLT.Conclusion Both slow and rapid LNLTs could be used to evaluate the accommodation to a meal and visceral sensitivity of the proximal stomach.The visceral sensitivity is related to the accommodation function.TVDRI of slow LNLT is more sensitive in estimating the visceral sensitivity of the proximal stomach;MVDRI of rapid LNLT is more accurate in estimating the accommodation of the proximal stomach.

Objective To investigate the pathophysiology mechanism in belching by using high resolution manometry combined with impedance monitoring.Methods Ten belching patients (four male and six female,ages ranged from 28 to 50 years) received high resolution manometry combined with impedance monitoring.The characters of esophageal motility at rest,swallowing and belching and the possible mechanism of belching were analyzed.Results Nine of 10 patients had esophageal peristaltic dysfunction,displaying as non-peristaltic contraction such as non-conduction contraction,interrupt contraction and dropping contraction.The pressure of the lower esophageal sphincter (LES) of three patients decreased.LES of one patient had incomplete relaxation.Nine of 10 patients were supragastic belching,in which air moved rapidly into esophagus and reversed exited from the mouth in one second.Among nine supragastic belching patients,the pleural pressure of seven patients increased during inspiration,upper esophageal sphincter relaxed and air was mistaken into the esophagus.The pharyngeal muscle contracted in two patients and the air was forced into esophagus.Of all the patients,intragastric and esophageal pressure increased through abdominal muscles and diaphragm contraction and air exited from the mouth.Conclusions The results of this study indicated that there was esophageal peristaltic dysfunction in belching patients.There was no frequently air swallowing in excessive belching patients,the typical belching model was supragastic belching.

Objective To investigate the effect of autonomic nervous dysfunction on pathogenesis of gastro-esophageal reflux disease(GERD).Methods Autonomic nervous function(ANF) was assessed by cardiovascular reflex tests in healthy volunteers and patients with GERD;Based on the ANF test results,the relationship between the impairment degree of autonomic nerve and the esophageal motility or the reflux esophagitis or the score of reflux symptoms was investigated.Results ① 59.5% of patients with GERD have abnormal ANF and the rate in GERD patients is much higher than that in healthy volunteers,parasympathetic nerve impairment is predominant.② The score of reflux symptoms in patients with normal ANF is significantly lower than that in patients with abnormal ANF(6(2,7.6)vs 9(4.1,17),P

Objective To evaluate influencing factors of the long-term maintenance therapy in patients with gastroesophageal reflux disease (GERD).Methods 156 Patients with GERD were divided into on-demand therapy group and continuous therapy group by their treatment,according to symptom relief and improvement of quality of life in the course of therapy.The relationship between treatment and course,symptoms, esophageal motility,24-h pH monitoring and endoscopic findings were analysed.Results (1)5 Patients showed no response to acid suppression therapy and were excluded.For the 151 patients,92 were in on-demand therapy group,and 59 were in continuous therapy group.(2)The disease course and symptoms score in on-demand therapy group were significantly longer and higher than those of continuous therapy group (P

Objective To explore the effects of balloon dilatation on esophageal motility in patients with achalasia. Methods Forty eight patients were diagnosed as having achalasia by clinical features, barium radiography, endoscopy and esophageal manometry (PC polygraf HR, Medtronic). The following parameters were evaluated: the symptom score, the maximal width of the esophagus (MWE) on barium radiography, lower esophageal sphincter pressure (LESP), lower esophageal sphincter relaxation rate (LESRR) and the contraction amplitude of esophageal body before and after dilatation at 4 weeks and 12～24 weeks. Results (1) Parameters of symptom score and the maximal esophagus width were significantly decreased ( P

Objective To evaluate the effect of integrative therapy and influencing factors in patients with intractable constipation (IC). Methods Eighty-four consecutive IC patients were divided into non overlap and overlap groups. All patients received individualized integrative therapeutic regimen for 4 weeks. The symptom scores of constipation and total effective rates were evaluated. Influencing factor of therapeutic effect in IC was analyzed.Results (1) IC of overlap group and non overlap group accounted for 40.5% (34/84) and 59.5% (50/84), respectively. (2)The total effective rates were 50.0% and 78.0% in overlap and non-overlap group, respectively(P

Objective To determine the postprandial acid distributions in patients with gastroesophageal reflux disease (GERD), and their potential relationship with esophageal acid exposure. Methods Esophageal and gastric pH were recorded in a 1 h fasting segment and a 4 h postprandial segments using a triple-channel pH catheter with three antimony electrodes, which were positioned 5 cm proximal to the upper margin of LES(LES-5 cm), 5 cm and 10 cm distal to the upper margin of LES(LES+5 cm and LES+10 cm), respectively. Esophageal acid exposure and gastric integrated acidity (IA) were calculated for each ambulatory pH study. Ten healthy subjects (HS) and 10 patients with GERD were enrolled. Results (1) Total postprandial IA had a trend to be lower at LES+5 cm than at LES+10 cm in HS, but there was no significant difference between the two positions in patients with GERD. (2)Two hours after meal, there was no significant difference of gastric IAs and baseline in HS. Whereas gastric IAs in patients with GERD returned back to a higher level than baseline: LES+5 cm: 5.4 (1.8-6.8) mmol/L?h vs 1.8(0.3-3.1) mmol/L?h (P