Kim, Keum-ji;Jeon, Hye-jin;Ko, Seok-jae;Park, Jae-woo
The Journal of Internal Korean Medicine
/
v.41
no.6
/
pp.1030-1051
/
2020
Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.
Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even when asymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most common gastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress are frequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asian countries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depression on Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care center in Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome III criteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The Hospital Anxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was defined as positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FD patients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patients with PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety and depression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depression were significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and 29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9, respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patients and more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of Thai FD patients and prevent the development of gastric cancer.
Kim, So-Yeon;Yoon, Sang-Hyup;Kim, Yoon-Bum;Jung, Sung-Ki
The Journal of Internal Korean Medicine
/
v.29
no.2
/
pp.401-412
/
2008
Objectives : The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with gastric dysmotility in functional dyspepsia(FD). Methods : Subjects were 154 patients with FD and 18 patients with asthma. We calculated the average Ryodoraku score(RS, ${\mu}A$) and each variation from physiologic range of 12 Ryodoraku points, and investigated the incidence when left and right points were simultaneously below(bilateral deficiency) or above(bilateral excess) physiologic range. Postprandial regularity of normal slow waves, power ratio, and postprandial % of bowel sound were obtained by electrogastrography and enterotachography, and were used as gastric dysmotility index. Results : 1. Bilateral excess of H4, H5, F1, and F4 and bilateral deficiency of H4, H5, and H6 were characteristic in FD compared with asthma patients. 2. Incidence of gastric dysmotility in bilateral deficiency of H4, H5, and H6 was 100%, and was higher than in total FD patients(88.3%). 3. There was a positive correlation between the variation of H6 and % postprandial bowel sound. 4. Deficient tendency of H4, H5, and H6 was more evident when RS was above $40{\mu}A$ in FD. Conclusions : These findings suggest that gastric dysmotility in FD can be diagnosed when a pattern of H4, H5, H6 bilateral deficiency and F1, F4 bilateral excess is shown at the same time. We think this phenomenon is related to low activity of the vagus nerve rather than meridian pathway with result based on positive correlation between variation of H6 and postprandial % of bowel sound.
Kim, Jihye;Ko, Seok-jae;Park, Jae-woo;Kim, Keun Ho
The Journal of Internal Korean Medicine
/
v.39
no.4
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pp.637-644
/
2018
Objectives: In this study, the tongue features of patients with functional dyspepsia (FD) were compared with those of healthy controls. Methods: This prospective, case-control study was conducted on patients with FD and controls recruited at a single center. After screening, the subjects were allocated to the patient or control groups (patients=42, controls=40). Tongue images were acquired using a computerized tongue image acquisition system (CTIS). An independent t-test was conducted to compare the measurements from patients and controls. Binary logistic regression was performed to determine significant differences between the two groups after adjusting for age and sex. Results: The CIE $a^*$ color value in the tongue coating area was significantly lower in the patients with FD than in the controls (p=0.001). The tongue coating ratios were also significantly higher in the FD group than in the control group (p=0.003). We found that the CIE $a^*$ color value in the tongue coating area and the tongue coating ratios were significant predictive factors in both groups, based on binary regression analysis (p=0.016, 0.044, respectively). Conclusions: This study found that FD was significantly associated with CIE $a^*$ color value in the tongue coating area and tongue coating ratios. We suggest that these factors could be used as objective indicators of FD.
As a disease that reduces quality of life, functional dyspepsia (FD) is associated with foods that may worsen its symptoms or cause it. The purpose of this study was to examine the nutritional status and dietary behaviors of FD patients. We investigated food intake, food intake frequency, and dietary habits of 45 FD subjects according to the Rome III Diagnosis Criteria. Average age and body mass index (BMI) were 47.7 years and $22.6kg/m^2$ (males: $23.4kg/m^2$, females: $22.1kg/m^2$), respectively. Average energy intake was 77% of Korean Dietary Reference Intake (KDRI), and it was less than that of the Korea National Health and Nutrition Examination Surveys (KNHANES). Other nutrient intake levels were similar to the KNHANES. Energy intake proportion of carbohydrates : protein : fat was 56 : 18 : 26, and the ratio of fat intake was higher than that of the KNHANES. Beans, laver, tomato, and yogurt were consumed very frequently. In the results of meal regularity, dietary behaviors and composition of diet were relatively good. It is likely that the patient controlled their diet by eating cautiously and by reducing alcohol drinking and smoking. Our results indicate that FD patients' nutritional status by consumption of nutrients was at a level of normal healthy people and that dietary habits were better than normal adults. However, their fat intake levels were somewhat higher than normal people. Therefore, further research is required to identify the relationship between dietary intakes and FD.
Little is known concerning the pathophysiology and symptomatology of gastric dysmotility of patients who have sought treatment in eastern traditional medicine. The aim of this study was to investigate gastric electrical activity and clinical characteristics between gastroparesis and non-gastroparetic functional dyspepsia(FD) and assess the necessity to distinguish them for eastern traditional medical treatment. 60 patients were surveyed by questionnaire. Gastric electrical activity was recorded and analyzed using electrogas-trography. Patients were divided into gastroparesis and non-gastroparetic FD by 1.0 of power ratio. Healthy persons were used as reference. Postprandial normogastria of gastroparesis decreased and that of non-gastroparetic functional dyspepsia increased compared before and after meals. Suggested causes of onset were the meat diets that most patients were on in the gastroparesis group, and that drugs that patients in the non-gastroparetic FD group were taking. Distribution of main symptom was equally regular in patients with gastroparesis, but patients with non-gastroparetic FD showed mainly upper abdominal pain and fullness. Values for the gastroparesis group were double those for the non-gastroparesis FD group in frequency of upper GI endosopic examination. Results suggest that effective application of eastern traditional medical treatment requires that first a clear distinction be made in state of gastric dysmotility and clinical characteristics of gastroparesis and non-gastroparesis FD when treating dyspepsia.
Objectives This study was aimed to compare effects of Yukgunja-tang (YGJT) extract granule on functional dyspepsia (FD) by sasang constitution. Methods A placebo-controlled, double-blind, randomized, two-center trial was performed. We obtained 3D face images of FD patients participating in this study using face-only scanner and classified them into two types as narrow face and wide face by 3D facial shape diagnosis system (3-FSDS). 96 subjects (48 subjects per type) were enrolled and were randomly allocated into treatment or control groups in a 2:1 ratio. YGJT extract granule or placebo were administered to each group during the 8 week treatment period. One of sasang constitutional specialist diagnosed their constitutions by referring to questionnaires and 3D face images. The primary outcome was total dyspepsia symptom scale (TDS scale), the secondary outcomes were single dyspepsia symptom scale (SDS scale), visual analog scale (VAS) and so on. This trial was registered with clinical research information service identifier: KCT0001920, 15 May, 2016. Results In the Taeeumin treatment group, the TDS scale was significantly decreased after 8 weeks compared to the control group (t=2.331, p=0.025) and the SDS scale also significantly decreased. (t=2.042, p=0.048). The specific effects of the YGJT extract granule without the placebo effect on the Taeeumin with functional dyspepsia were 30.61% in TDS scale and 28.33% in SDS scale. Conclusions The effects of Yukgunja-tang extract granule on functional dyspepsia was different according to Sasang constitution. So the constitution should be considered in randomized controlled trials using herbal extract granules.
Kim, Keum-ji;Cho, Soo-ho;Park, Ji-seon;Ko, Seok-jae;Park, Jae-woo
The Journal of Internal Korean Medicine
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v.40
no.6
/
pp.1268-1277
/
2019
Objective: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of functional dyspepsia in a fibromyalgia patient with a history of long-term NSAIDs use. Methods: The patient was diagnosed as a Soeumin, one of the four constitution types in Korean medicine, and treated with herbal medicines such as Seungyangikgibuja-tang and Pyeongjinsunjeom-san. Acupuncture and moxibustion treatment were also performed. The severity of symptoms was assessed using the Numerical Rating Scale (NRS) of epigastric pain, daily oral intake changes, the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Gastrointestinal Symptom Score (GIS), and the Functional Dyspepsia-Quality of Life (FD-QOL) score. Results: After treatment for 48 days, the severity of epigastric pain decreased from NRS 8 to NRS 0, and daily oral intake was increased. The KGSRS score decreased from 55 to 43, the GIS score was reduced from 18 to 10, and the FD-QOL score also decreased from 69 to 55. Conclusions: This study suggests that Korean medical treatment could be an effective option for treating functional dyspepsia in fibromyalgia patients with a history of long-term NSAIDs use.
Objective: This study was designed to investigate the correlation between gastric emptying measurement by ultrasonography and the findings of various questionnaires of functional dyspepsia (FD) or in Korean medicine to explore the possibility of quantification of questionnaires. Methods: Eighty-eight patients (44 patients with FD and 44 healthy controls) were recruited from October 2016 to November 2017. Gastric emptying half-time (T1/2) was measured by ultrasonography at fasting, and at 0, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 ml, 224 kcal). The average half-time (average T1/2) was calculated by averaging all measured half-times. A visual analogue scale (VAS), food retention questionnaire (FRQ), damum questionnaire (DQ), cold and heat questionnaire (CHQ), deficiency and excess questionnaire (DEQ), spleen-qi deficiency questionnaire (SQDQ), Nepean dyspepsia index-Korean version (NDI-K), and quality of life of NDI (NDI-QoL) were filled out by all participants. Correlation between the average T1/2 and questionnaires were analyzed for 79 patients (37 patients with FD and 42 healthy controls) after excluding missing and erroneous data. Results: The FRQ, DEQ, SQDQ, NDI-K, and NDI-QoL scores, especially for some gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Our results suggest that gastric emptying measurement by ultrasonography may be a quantitative substitute method for some Korean medical questionnaires or for some dyspepsia-related and deficiency-related items among them. However, further studies using various measurements of gastric emptying will be needed.
Cho, Yun-jae;Lee, Hanul;Jeong, Hae In;Lee, Hyun-Jin;Keum, Chang-Yul;Han, Aram;Ha, Na-Yeon;Kim, Jinsung
The Journal of Internal Korean Medicine
/
v.42
no.4
/
pp.488-509
/
2021
Purpose: Functional dyspepsia (FD) is a chronic syndrome accompanied by repetitive digestive symptoms that appear in the upper gastrointestinal tract and are not caused by specific diseases. Psychological symptoms like anxiety, depression, insomnia, and somatization are frequently observed in FD. The purpose of this study was to review the effect of herbal medicine on the psychological symptoms that accompany FD. Methods: Database search (PubMed, EMBASE, KISS, Kmbase, KoreanMed, NDSL, OASIS, CNKI) was performed on February 24, 2021; a total of 1825 studies were searched. After the screening, 22 studies were included. Results: The studies were assessed by Cochrane RoB 2 and sorted into a table according to psychological symptoms. Meta-analysis was performed to estimate the effect of herbal medicine. Twenty of the twenty-two studies reported that herbal medicine was significantly more effective than the control group. Only three of the studies did not have a high risk of bias. Conclusion: Herbal medicine was significantly effective with or without Western medicine and had fewer adverse effects. Severe adverse effect was not reported. Psychological symptoms in FD affect onset and duration of FD, and some FD patients want to be treated for their anxiety before other symptoms. Reliable information about treatment for the psychological symptoms of FD is lacking. We reviewed the effect of herbal medicine treatment in this study, the results of which could be selected for primary or secondary treatment for FD.
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