| Theme |
Diagnosis and Treatment of Non-ulcer Dyspepsia |
| Title |
Abnormal Visceral Perception in Non-ulcer Dyspepsia |
| Author |
Hiroshi Kaneko |
Pathophysiology and Therapeutics, Aichi Medical University College of Nursing, Aichi Medical University School of Medicine |
| Author |
Toshihiro Konagaya |
Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Medicine |
| Author |
Chikara Yamaguchi |
Department of Internal Medicine, Division of General Medicine, Aichi Medical University School of Medicine |
| Author |
Hiroshi Imamura |
Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Medicine |
| Author |
Kazuo Kusugami |
First Department of Internal Medicine, Nagoya University School of Medicine |
| Author |
Shinichi Kakumu |
Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Medicine |
| [ Summary ] |
The pathophysiology of non-ulcer dyspepsia (NUD) still remains unclear. Abnormal visceral perception may play a role in NUD, because a lower threshold for intragastric balloon distension exists in NUD, compared to normal volunteers. The implications of gastric topical neuropeptides (neurotransmitters), such as substance P and calcitonin gene-related peptides, in capsaicin sensitive primary afferent sensory neurons and the involvement of the afferent pathway of the vagus to convey the sensory input against noxious stimuli from the gastric mucosa to the brain stem have been proposed. The standard method for measuring the threshold of visceral sensation is the barostat technique, however it has many limitations. 'Water drink test' for calculating the maximal volume of non-caloric or caloric water intake and 'capsaicin load test', in which a dyspeptic response to a small dose of oral capsaicin ingestion is examined, are reported to be simple alternative methods to carry out the barostat technique. Recently, a beneficial effect of long term capsaicin treatment for dyspepsia in NUD has been reported. Abnormal visceral perception is one important pathoetiology to explain dyspeptic symptoms in NUD, in relation to brain-gut interactions. |