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Su2073 Lactose Intolerance in Chinese Patients With Functional Bowel Disease
anxiety and depression scale (HADs) and general personal information was completed. Results: Among the 880 patients (44±12 yr, 44% female) and 64 healthy volunteers (41±15 yr, 48% female) studied, the prevalence of lactose intolerance was 59.9% (n=527) and 28.1% (n=18) respectively. The prevalence of LI was higher in patients with functional bowel symptoms (P,0.0001). Further, the prevalence of LI in the patients increased with LHBT dose: 10g LHBT of prevalence (n=51, 18%), 20g (n=285, 58%), 40g (n=263, 71%). Patients with LI were slightly younger than non-LI (43±12 vs. 45±12 yr, P=0.009) The proportion of patients with LI increased with the educational level (P=0.04), while other factors such as gender, occupation, life event score, depression or anxiety status were not different between the LI and non-LI patients. Compared with non-LI patients, LI patients more often reported bowel movement less than 3 times per week (P=0.007) and straining during bowel movement (P=0.044). The frequency of other FBD symptoms and the severity of overall symptoms (P=0.228) was similar in both LI and non-LI groups. 785 patients were confirmed as FBD, and the remaining 95 patients did not meet the diagnostic criteria for symptom duration. Of the former group, 475 (54.0%) were IBS, 165 (18.8%) functional diarrhea, 75 (8.5%) functional constipation, 46 (5.2%) functional bloating, and 24 (2.7%) undefined FBD. The prevalence of functional disease or each FBD subtype was not significantly different between LI and non-LI patients. Conclusions: Our study showed that the lactose intolerance was commoner in Chinese patients with functional bowel disease than healthy subjects. Young age and high educational level were associated with LI development in FBD patients. FBD patients who were lactose intolerant more frequently reported constipation; however the frequency and severity of other symptoms was not affected. General characteristics and LI associated factors of patients with functional bowel symptom
The Bitter Taste Receptor Agonist Denatonium Benzoate Alters Intragastric Pressure Profiles During Nutrient Drink Test in Healthy Volunteers Christopher N. Andrews, Sofie Verschueren, Pieter Janssen, Anne Maes, Eveline Deloose, Inge Depoortere, Jan F. Tack Background: Bitter taste receptors are expressed in the stomach and the duodenum but their function is unclear. We assessed the effects of a potent bitter tastant on intragastric pressure (IGP, a measure of gastric accommodation) and satiation in response to a liquid meal. Methods: We conducted a single-blind crossover trial of 16 healthy volunteers (8 female; mean age 30±2 yrs; mean BMI 23.8±0.9) given 1 μmol/kg (0.1mL/kg) of a 10mM denatonium benzoate (DB) solution or placebo in random order on separate occasions at least 1 week apart. First, both a standard high-resolution manometry (HRM) catheter and a 4mm feeding catheter were positioned intra-gastrically via the nose with location confirmed by detection of the lower esophageal sphincter (LES) and/or fluoroscopy. After an adjustment period, DB or placebo was administered through the feeding catheter. After 30 min, nutrient drink (ND; 30% fat, 42% carbohydrate, 28% protein) was infused into the stomach at 60mL/ min until maximum satiation, at which point it was stopped. Satiation (scored on 0-5 scale) was assessed every minute. IGP was measured as average pressure over 5 channels in the proximal stomach at least 1cm below the LES, with 5-minute baseline measured 10 minutes before ND start. Outcomes were compared with paired t-test or Wilcoxon test as appropriate. All data are expressed as mean ± SEM unless otherwise stated. Results: Baseline IGP prior to ND infusion was similar between DB and placebo (Table). After DB treatment, the nutrientinduced drop in IGP from baseline (baseline-nadir) was inhibited (p=0.056) and delayed (p=0.007) compared to placebo. The total area under the IGP curve during nutrient infusion was significantly smaller after DB (p=0.021), consistent with attenuation of the gastric accommodation response (Figure). Satiation score at nadir IGP tended to be higher after DB vs placebo (p=0.087). The volume of ND ingested and the duration of the nutrient infusion were not statistically different between groups. No adverse effects were noted after either agent. Conclusion: The potent bitter tastant DB inhibits gastric accommodation to a meal, independently of taste receptor stimulation in the tongue. The mechanism and receptors involved in this action warrant further study.
FBD symptoms in LI patients
Su2074 Gastrointestinal (GI) Symptoms Induced by Spicy, Sour, and Fatty Food Ingestion in Functional Dyspepsia (FD): A Difference Between Epigastric Pain Syndrome (EPS) and Postprandial Distress Syndrome (PDS) Tanisa Patcharatrakul, Prima Singhagowinta, Pinit Kullavanijaya, Sutep Gonlachanvit Spicy, sour, and fatty foods often aggravate gastrointestinal symptoms in patients with FD. Whether there is different symptom response to these specific foods between EPS and PDS has not been well explored. Methods: 283 consecutive dyspeptic patients (191F, age46±15yr) who had normal upper endoscopy were interviewed regarding frequency and severity of each upper and lower GI symptoms and history of GI symptoms induced by spicy, fatty or sour foods. Patients were classified as epigastric pain syndrome (EPS)(n=127), postprandial distress syndrome (PDS)(n=60) and mixed EPS-PDS(n=96) using the symptoms profiles described in the Rome III criteria. Patients with overlapping FD with other functional GI disorder were excluded. The data from FD patients were compared with 100 asymptomatic healthy volunteers (HV)(65F, age41±7yr). Results: 195 of the 283(69%) FD patients had GI symptoms induced by at least one of the 3 foods (spicy, fatty or sour) ingestion. This prevalence was higher than HV (n=12/100)( p ,0.001). There was higher prevalence of spicy and sour foods induced GI symptoms in EPS and EPS+PDS patients than PDS patients (p,0.05) (see table). In contrast, there was higher prevalence of fatty foods induced GI symptoms in PDS than EPS and EPS+PDS (p ,0.05). The most common symptoms induced by spicy foods were epigastric burning and/or pain which developed in 76 of 80 EPS, 21 of 28 PDS and 67 of 70 mixed EPS+PDS patients who had GI symptom(s) induced by spicy foods. 12 HV developed GI symptom after spicy foods and 9 of these 12 volunteers developed epigastric burning/pain. 98(35%) FD patients had GI symptoms after sour foods. Epigastric burning/pain were also the most common symptoms induced by sour foods in FD. These symptoms were developed in 35 of 38 EPS, 10 of 15PDS, and 42 of 45 EPS+PDS patients who had GI symptom(s) induced by sour foods. Only one HV developed symptom from both spicy and sour food which was diarrhea. 48(17%) FD patients had GI symptoms induced by fatty foods ingestion. Postprandial fullness was the most common symptom induced by fatty foods which developed in 12 of 16 EPS, 15 of 18 PDS, and 10 of 14 of mixed EPS-PDS patients who had GI symptom(s) induced by fatty foods, while HV had no GI symptom induced by fatty foods. Conclusions: Hypersensitivity to fatty, spicy and sour foods is present in FD. Spicy and sour foods ingestion induced mainly epigastric burning or pain, especially in EPS. Whereas, fatty foods induced mainly postprandial fullness symptoms, especially in PDS. This study suggests that EPS and PDS are 2 distinct GI conditions and they may need different dietary recommendation.
Su2073 Lactose Intolerance in Chinese Patients With Functional Bowel Disease Liang Luo, Yanyong Deng, Hua Chu, Jianfeng Yang, Yanqin Long, Xia Zheng, Zhihui Huang, Yubin Zhu, Huiqin He, Michael Fried, Ning Dai, Mark R. Fox Background: Accumulating evidence indicates a high prevalence of lactose intolerance (LI) in patients with functional bowel disease (FBD) such as irritable bowel syndrome (IBS). However, the underlying factors that determine the risk of LI in this group and whether certain FBD symptoms are more common in patients with LI remains uncertain. Methods: 880 consecutive patients seen for assessment of functional bowel symptoms were recruited from a single University Hospital in Southeastern China, and 64 healthy volunteers were recruited through public advertisement. All patients were randomly assigned a lactose hydrogen breath test (LHBT) of lactose dose of 10g, 20g, or 40g, with the measurement of hydrogen production and LI symptom scores. A questionnaire containing Rome III criteria, hospital
S-549
AGA Abstracts
AGA Abstracts
Su2072
The Bitter Taste Receptor Agonist Denatonium Benzoate Alters Intragastric Pressure Profiles During Nutrient Drink Test in Healthy Volunteers Christopher N. Andrews, Sofie Verschueren, Pieter Janssen, Anne Maes, Eveline Deloose, Inge Depoortere, Jan F. Tack Background: Bitter taste receptors are expressed in the stomach and the duodenum but their function is unclear. We assessed the effects of a potent bitter tastant on intragastric pressure (IGP, a measure of gastric accommodation) and satiation in response to a liquid meal. Methods: We conducted a single-blind crossover trial of 16 healthy volunteers (8 female; mean age 30±2 yrs; mean BMI 23.8±0.9) given 1 μmol/kg (0.1mL/kg) of a 10mM denatonium benzoate (DB) solution or placebo in random order on separate occasions at least 1 week apart. First, both a standard high-resolution manometry (HRM) catheter and a 4mm feeding catheter were positioned intra-gastrically via the nose with location confirmed by detection of the lower esophageal sphincter (LES) and/or fluoroscopy. After an adjustment period, DB or placebo was administered through the feeding catheter. After 30 min, nutrient drink (ND; 30% fat, 42% carbohydrate, 28% protein) was infused into the stomach at 60mL/ min until maximum satiation, at which point it was stopped. Satiation (scored on 0-5 scale) was assessed every minute. IGP was measured as average pressure over 5 channels in the proximal stomach at least 1cm below the LES, with 5-minute baseline measured 10 minutes before ND start. Outcomes were compared with paired t-test or Wilcoxon test as appropriate. All data are expressed as mean ± SEM unless otherwise stated. Results: Baseline IGP prior to ND infusion was similar between DB and placebo (Table). After DB treatment, the nutrientinduced drop in IGP from baseline (baseline-nadir) was inhibited (p=0.056) and delayed (p=0.007) compared to placebo. The total area under the IGP curve during nutrient infusion was significantly smaller after DB (p=0.021), consistent with attenuation of the gastric accommodation response (Figure). Satiation score at nadir IGP tended to be higher after DB vs placebo (p=0.087). The volume of ND ingested and the duration of the nutrient infusion were not statistically different between groups. No adverse effects were noted after either agent. Conclusion: The potent bitter tastant DB inhibits gastric accommodation to a meal, independently of taste receptor stimulation in the tongue. The mechanism and receptors involved in this action warrant further study.
FBD symptoms in LI patients
Su2074 Gastrointestinal (GI) Symptoms Induced by Spicy, Sour, and Fatty Food Ingestion in Functional Dyspepsia (FD): A Difference Between Epigastric Pain Syndrome (EPS) and Postprandial Distress Syndrome (PDS) Tanisa Patcharatrakul, Prima Singhagowinta, Pinit Kullavanijaya, Sutep Gonlachanvit Spicy, sour, and fatty foods often aggravate gastrointestinal symptoms in patients with FD. Whether there is different symptom response to these specific foods between EPS and PDS has not been well explored. Methods: 283 consecutive dyspeptic patients (191F, age46±15yr) who had normal upper endoscopy were interviewed regarding frequency and severity of each upper and lower GI symptoms and history of GI symptoms induced by spicy, fatty or sour foods. Patients were classified as epigastric pain syndrome (EPS)(n=127), postprandial distress syndrome (PDS)(n=60) and mixed EPS-PDS(n=96) using the symptoms profiles described in the Rome III criteria. Patients with overlapping FD with other functional GI disorder were excluded. The data from FD patients were compared with 100 asymptomatic healthy volunteers (HV)(65F, age41±7yr). Results: 195 of the 283(69%) FD patients had GI symptoms induced by at least one of the 3 foods (spicy, fatty or sour) ingestion. This prevalence was higher than HV (n=12/100)( p ,0.001). There was higher prevalence of spicy and sour foods induced GI symptoms in EPS and EPS+PDS patients than PDS patients (p,0.05) (see table). In contrast, there was higher prevalence of fatty foods induced GI symptoms in PDS than EPS and EPS+PDS (p ,0.05). The most common symptoms induced by spicy foods were epigastric burning and/or pain which developed in 76 of 80 EPS, 21 of 28 PDS and 67 of 70 mixed EPS+PDS patients who had GI symptom(s) induced by spicy foods. 12 HV developed GI symptom after spicy foods and 9 of these 12 volunteers developed epigastric burning/pain. 98(35%) FD patients had GI symptoms after sour foods. Epigastric burning/pain were also the most common symptoms induced by sour foods in FD. These symptoms were developed in 35 of 38 EPS, 10 of 15PDS, and 42 of 45 EPS+PDS patients who had GI symptom(s) induced by sour foods. Only one HV developed symptom from both spicy and sour food which was diarrhea. 48(17%) FD patients had GI symptoms induced by fatty foods ingestion. Postprandial fullness was the most common symptom induced by fatty foods which developed in 12 of 16 EPS, 15 of 18 PDS, and 10 of 14 of mixed EPS-PDS patients who had GI symptom(s) induced by fatty foods, while HV had no GI symptom induced by fatty foods. Conclusions: Hypersensitivity to fatty, spicy and sour foods is present in FD. Spicy and sour foods ingestion induced mainly epigastric burning or pain, especially in EPS. Whereas, fatty foods induced mainly postprandial fullness symptoms, especially in PDS. This study suggests that EPS and PDS are 2 distinct GI conditions and they may need different dietary recommendation.
Su2073 Lactose Intolerance in Chinese Patients With Functional Bowel Disease Liang Luo, Yanyong Deng, Hua Chu, Jianfeng Yang, Yanqin Long, Xia Zheng, Zhihui Huang, Yubin Zhu, Huiqin He, Michael Fried, Ning Dai, Mark R. Fox Background: Accumulating evidence indicates a high prevalence of lactose intolerance (LI) in patients with functional bowel disease (FBD) such as irritable bowel syndrome (IBS). However, the underlying factors that determine the risk of LI in this group and whether certain FBD symptoms are more common in patients with LI remains uncertain. Methods: 880 consecutive patients seen for assessment of functional bowel symptoms were recruited from a single University Hospital in Southeastern China, and 64 healthy volunteers were recruited through public advertisement. All patients were randomly assigned a lactose hydrogen breath test (LHBT) of lactose dose of 10g, 20g, or 40g, with the measurement of hydrogen production and LI symptom scores. A questionnaire containing Rome III criteria, hospital
S-549
AGA Abstracts
AGA Abstracts
Su2072