Takatsugu Machida

The features of adolescent irritable bowel syndrome in Japan.

Objective and Background:  The onset of IBS is in adolescence in many cases. However, the features of adolescent IBS were generally lacking. The objective of this research was to know the features of adolescent IBS in Japan.

When and How Should We Study Colonic Motility

The colon has an autonomic activity owing to the concerted actions of the interstitial cells of Cajal, the enteric nervous system (especially myentric plexus and submucosal plexus), and smooth muscle

Pharmacological and psychosomatic treatments for an elderly patient with severe nausea and vomiting in reaction to postoperative stress

Here we present a case of successful treatment employing a mixed approach including pharmacological and psychosomatic treatments for a 72-year-old woman who experienced severe nausea and vomiting in reaction to postoperative stress from gastric cancer surgery. This case demonstrates that appropriate provision of psychosomatic treatments, including a psychotherapeutic session and autogenic training, enhances the efficacy of pharmacotherapy.

M1309 Virtual Visual Stress Enhances Gastric Hypersensitivity in Functional Dyspepsia

[Background] Psychological stress is one of the strong triggers that induce gastric symptoms in functional dyspepsia. Previously we reported that in healthy subjects virtual stress induced increase of gastric volume and gastric hypersensitivity, which relate to the pathophysiology of functional dyspepsia. [Aim] We tested our hypothesis that psychological stress can induce excessive changes of gastric volume and sensation in functional dyspepsia than in healthy subjects. [Subjects & Methods] Nine functional dyspepsia non-consulters (FD) and 9 healthy subjects (HS) were recruited in this study. Virtual visual stress (VS) was loaded with a 3D roller coaster movie for 10 minutes by the head-mounted display. Gastric volume and compliance were measured by barostat technique during the virtual stress session. At the beginning and end of the VS session, gastric perception was evaluated by barostat bag distention, then 3 perception thresholds were defined (first sensation (F), discomfort (D), and pain (P)). Subjective gastric perception and stress sensation during the stress were evaluated on the gastric symptom questionnaires consisted of 7 graded ordinate scales. [Results] During VS, FD reported higher stress sensation than in HC (p=0.0163, ANOVA). VS induced gastric volume increase both in FD and in HS (p=0.001). However, the changes of gastric volume in FD were not different in HS (p=0.88, ANOVA). Basal gastric perceptional thresholds were significantly lower in FD than in HS (p<0.001). After VS session, gastric perceptional thresholds significantly decreased in both FD and HS (p<0.001 ANOVA, vs. basal thresholds). Nausea symptom was moderate but remarkably induced in FD during VS compared with HS. [Summary] Virtual stress remarkably reduced gastric perceptional thresholds in functional dyspepsia, which suggested that psychological stress induce gastric symptoms by enhancing gastric hypersensitivity. Effects of VS on gastric volume and perception in FD and HS

M2020 The Effect of Histamine 2 Receptor Antagonist on Cerebral Evoked Potentials During Visceral Stimulation in Functional Dyspepsia: Double Blind Randomized Placebo Controlled Study

Genetic variations of potential modulators of gastrointestinal sensory and motor function appear to influence the genesis of symptoms. Ghrelin has enhancing effects on gastrointestinal motility and gastric emptying. Furthermore, it has been shown that plasma ghrelin levels are altered in patients with FD of the dysmotility type. We aimed to assess the association of preproghrelin gene polymorphisms with the susceptibility to subgroups of FD and subgroups of IBS in a Korean population. 600 households in the city of Gwangju were randomly selected by multistage systemic sampling, using a computerized sampling procedure. Those older than 19 years of age were considered eligible. Of the selected eligible subjects, 1056 individuals completed the questionnaire and allowed blood sampling. The questionnaire requested information on demographics and Rome III criteria for the diagnosis of FD and IBS. Validated six SNPs in the preproghrelin gene were selected from a public SNP database (HapMap data), based on minor allele frequencies and the linkage disequilibrium relationship. In a preliminary study using DNA samples from FD and IBS patients recruited at outpatient clinic of Ajou University Hospital, we found that three SNPs (+1069G>A (rs42451), -1500C>G (rs3755777), Leu72Met (C>A) (rs696217)) were significantly associated with FD or IBS. Thus, these SNPs were finally chosen for validation in the present study. The allelic discrimination of SNPs on the basis of the TaqMan technology was performed. Based on the symptoms assessed by the Rome III criteria, 167 subjects were diagnosed as FD alone, 60 subjects as IBS alone, and 85 subjects as the coexistence of FD and IBS. 434 subjects who had no recurrent abdominal symptoms for the last 3 months were chosen as asymptomatic controls. The A allele of GHRL rs42451 was significantly associated with PDS (OR 1.385 (95% CI; 1.0041.908)). The AA genotype of GHRL rs42451 was significantly more frequent in PDS subgroup than in normal subgroup (OR 1.481 (95% CI; 1.016-2.160)). No SNPs were significantly associated with EPS and mixed FD subgroups. The G allele of GHRL rs3755777 was significantly associated with IBS-D (OR 0.762 (95% CI; 0.605-0.959)). The GG and CG genotypes of GHRL rs3755777 were significantly less frequent in IBS-D subgroup than in normal subgroup (OR 0.585 (95% CI; 0.346-0.989)). No SNPs were significantly associated with IBS-C and IBS-M subgroups. Preproghrelin gene genotypes may be predisposing factors to postprandial distress syndrome and IBS with diarrhea.