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#Gastroenterology #Hepatology #Multispeciality
Abnormalities in gastric sensorimotor function are associated with the symptomatology in several gastrointestinal diseases. Gastrointestinal symptoms are common in patients with cirrhosis that cause low energy intake resulting in malnutrition and increased morbidity. The current study is aimed to examine gastric accommodation to a meal and sensitivity to gastric distension with regard to energy intake, nutritional status and gastrointestinal symptoms in liver cirrhosis.
The study included 16 patients with cirrhosis and 15 healthy controls who underwent a gastric barostat study to examine gastric accommodation to a meal and sensory thresholds for first perception and discomfort. A slow caloric satiety drinking test was also performed on these patients. The authors also examined the food intake and nutritional status and a questionnaire was used to measure gastrointestinal symptoms.
The outcome of the study contrasted patients with cirrhosis with controls and revealed improved gastric accommodation but lower daily energy intake in cirrhotic patients. Patients with compromised nutritional status versus those without had better gastric accommodation. Gastric accommodation was associated to daily energy intake in controls but not in cirrhotic patients. The end-point of the satiety test was inversely linked to gastric volumes in cirrhotic patients. Mean post-meal balloon volumes were positively interconnected to the Model for End Stage Liver Disease (MELD) score. Although sensory thresholds did not vary between patients and controls, were reported to be linked with gastrointestinal symptom severity and cirrhosis severity scores in the patients.
Thus, the study concluded that though gastric accommodation is enhanced in cirrhotic patients, there appears to be some abnormalities in its association with energy intake. Moreover, the satiety drinking test cannot be regarded as a good surrogate marker of accommodation in cirrhotic patients. The severity of gastrointestinal symptoms is linked with the gastric sensitivity in patients with liver cirrhosis.
Source: Kalaitzakis E, Simrén M, Abrahamsson H, Björnsson E. Role of gastric sensorimotor dysfunction in gastrointestinal symptoms and energy intake in liver cirrhosis. Scand J Gastroenterol. 2007 Feb;42(2):237-46.