氢气甲烷呼气文献 (99)

Abstracts/Digestive and Liver Disease41S(2009),S1–S167S43

nal mucosa and serum of UC patients;2)IL-33and ST2are localized to both IEC and LP leukocytes;3)Changes in the pattern of ST2 expression occur during IBD.Taken together,our study is the?rst to report that IEC are a primary source of IL-33in the gut mucosa and that IL-33/ST2may play a central role in the pathogenesis of IBD.

#L.In?ammatory bowel diseases1.Basic science

OC.13.1

PREV ALENCE AND RISK FACTORS OF FUNCTIONAL DYSPEPSIA IN THE GENERAL POPULATION:LOIANO-MONGHIDORO STUDY

R.M.Zagari1,https://www.360docs.net/doc/1413679639.html,w2,L.Fuccio1,L.Eusebi1,D.Forman2,

F.Bazzoli1

1University of Bologna,Bologna;2University of Leeds,Leeds,UK Background and aim:Functional dyspepsia(FD)is the most common cause of dyspeptic symptoms,but its epidemiology in the community is still unclear.Our aim was to evaluate the prevalence and risk factors of FD in a representative sample of general population.

Material and methods:The study population was sampled as part of the Multicentre Italian Study on Cholelithiasis.1533adults from two villages(total adult population,6332)were approached to undergo symptoms assessment using a validated questionnaire,upper gastroin-testinal endoscopy with gastric biopsy and13C-urea breath test.Data were also collected on demographic and lifestyle characteristics and use of medication.Epigastric pain,post-prandial fullness and early satiety occurring for at least12weeks during the previous year without or with concomitant non prominent re?ux symptoms(both mild and less frequent than twice a week)in absence of endoscopic organic lesions were de?ned as FD symptoms(Rome II criteria).A logistic regression analysis was used to estimate potential risk factors for FD using as controls asymptomatic subjects without organic lesions.

Results:1033individuals were enrolled(67.4%).244(23.6%)subjects reported dyspeptic symptoms without(n.156)or with non prominent re?ux symptoms(n.88).Of the244subjects,62(25.4%)had organic lesions including esophagitis,Barrett’s esophagus,peptic ulcer(PU), erosions and malignancy,while182(74.6%)had FD symptoms.Of the 182subjects,45(24.7%)had epigastric pain,45(24.7%)epigastric pain and post-prandial fullness/early satiety and92(50.6%)post-prandial fullness/early satiety without epigastric pain.The prevalence of FD in the study population was17.6%(182/1033)(95%CI,15.1-20.4). Irritable bowel syndrome(OR5.76;95%CI,1.81-18.33),1st degree family history(FH)for gastric cancer(OR3.36;95%CI,1.51-7.44) and two occupations,that of clerk(OR4.78;95%CI,1.33-17.10)and manual worker(OR4.09;95%CI,1.10-15.32),were associated with an increased risk of FD.A borderline association was found with the divorced status(OR4.27;95%CI,0.98-18.7).Age,sex,education level, BMI,smoking,alcohol,coffee,H.pylori infection,chronic gastritis and 1st FH for PU were not risk factors for FD.

Conclusions:About17%of adults in the community suffer from FD. Subjects with IBS,positive FH for gastric cancer,clerks and manual workers had an increased risk of FD.

#M.Functional disorders1.Dyspepsia

OC.13.2

BREATH METHANE EXCRETION AND SEVERITY OF SYMPTOMS IN FUNCTIONAL BOWEL DISORDERS

M.Di Stefano?,C.Mengoli,A.Zanaboni,P.Tana,F.Racca,

S.Mazzocchi,G.R.Corazza

1st Department of Medicine,University of Pavia,Foundation IRCCS “S.Matteo”Hospital,Pavia

Background and aim:Colonic methane(CH4)production is the main pathway of hydrogen(H2)consumption;on a stechiometric basis,it is able to reduce total gas volume.Breath CH4excretion is detectable in35-50%of subjects and little information is available on a putative role of CH4in the physiopathology of functional symptoms.We have already shown that breath CH4excretion does not correlate with either a speci?c clinical presentation or the severity of functional symptoms (Di Stefano et al,DDW2008).The aim of this study was to assess whether colonic production of different breath CH4excretion patterns correlate with the presence and severity of symptoms in patients with functional bowel disorders.

Material and methods:137subjects,10healthy volunteers and127pa-tients with functional bowel disorders(106females,mean age40±10), were enrolled.10gr lactulose in250ml water were given orally after fasting;breath samples were collected every15min for7h for H2 and CH4detection.H2and CH4production was evaluated by the area under the time-concentration curve calculation(AUC).A cumulative gas excretion area was calculated by the sum of H2AUC and CH4 AUC.30patients showed both H2and CH4excretion with breath,97 excreted only H2(methane non-excretors).We subdivided the CH4 excretors into3patterns:subtype1=increase in H2excretion and stable CH4excretion(n=14);subtype2=reduction of CH4excretion when H2increases(n=10);subtype3=parallel increase of CH4and H2(n=6).The presence and severity of bloating,?atulence,abdominal pain and borborygmi were evaluated by a semiquantitative scale where 0=no symptom,3=severe symptom.

Results:Symptom severity did not differ among the three subtypes. Subtype2showed a cumulative AUC of H2and CH4signi?cantly lower than both subtype1and subtype3(subtype2:AUC=16052±5818 ppmxmin;subtype1:AUC=27372±24389ppmxmin;subtype3: AUC=27888±9358ppmxmin;P<0.05for all these comparisons)and higher than healthy volunteers(HV:AUC=7425±4948ppmxmin, P<0.05).A strong inverse correlation was found between the severity of each symptom and the cumulative excretion of gas:bloating R=-0.79,P<0.005;abdominal pain R=-0.72,P<0.05;?atulence R=-0.75, P<0.05,barborygmi R=-0.45,P=0.05.

Conclusions:In at least one subtype of methane-excretors the severity of symptoms is correlated with cumulative excretion of H2and CH4. #M.Functional disorders2.IBS

OC.13.3

RIMONABANT-INDUCED EARLY SATIETY IS ASSOCIATED WITH DECREASED GASTRIC COMPLIANCE AND INHIBITION OF GASTRIC ACCOMMODATION

E.Scarpellini?,1,K.Ameloot2,R.V os2,P.Vandenberghe2,

I.Depoortere2,J.Tack2

1Gemelli Hospital,Roma;2Leuven Hospital,Leuven,Belgium Background and aim:Satiety is partly controlled by the gastric ac-commodation(GA)and by the activation of descending endogenous anti-nociceptive pathways,putatively through mediators like endo-cannabinoids.The endocannabinoid receptor antagonist rimonabant (RI)has been shown to decrease food intake,mainly due to an effect on the central nervous system.We want investigate how suppression of endocannabinoid signalling by RI would in?uence the gastric response to meal ingestion and the sensitivity to gastric distension in normal volunteers.

Material and methods:9healthy subjects participated in a placebo-controlled,double blind,randomized,crossover gastric barostat study. After3days of pretreatment with RI20mg/day or placebo(PL), stepwise distensions were performed(2mmHg steps at2minute in-tervals,until discomfort or pain).To quantify gastric sensitivity,upper abdominal sensation was scored on graded scales(0=no sensation, 6=maximal)at the end of every distension step.To quantify gastric accommodation(GA),the mean gastric volume over consecutive5min intervals was measured30min before and60min after a standardized