Edrophonium provocative testing for the evaluation of upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia

• Published in: Digestive diseases and sciences 2006-08, Vol.51 (8), p.1302-1306
• Main Authors: TSUTSUI, Shinichi, MINE, Kazunori, HANDA, Masanori, HAYASHI, Haruo, HOSOI, Masako, KINUKAWA, Naoko, KUBO, Chiharu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Cholinesterase Inhibitors - administration & dosage; Dyspepsia - complications; Dyspepsia - diagnosis; Edrophonium - administration & dosage; Esophageal Motility Disorders - diagnosis; Esophageal Motility Disorders - etiology; Esophageal Motility Disorders - physiopathology; Esophagus - physiopathology; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hypersensitivity - diagnosis; Hypersensitivity - etiology; Hypersensitivity - physiopathology; Infusions, Intravenous; Male; Manometry; Medical sciences; Middle Aged; Other diseases. Semiology; Reproducibility of Results; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-005-9063-3

The aim of this study was to examine if edrophonium provocative testing is useful for evaluating upper gastrointestinal hypersensitivity in patients with nonulcer dyspepsia (NUD). A questionnaire rating dyspeptic symptoms was done for 58 patients with NUD. The patients were then given an intravenous infusion of saline followed by 5 mg of edrophonium. Baseline esophageal manometry was also done. Patients whose usual symptoms were reproduced (48.3%) had significantly higher symptom scores (13.0 [8.5, 17.0] vs. 8.5 [6.0, 11.0]; P = 0.015) and a significantly higher number of symptoms (4.0 [2.5, 6.0] vs. 3.0 [1.0, 4.0]; P = 0.010) than patients whose usual symptoms were not reproduced. The presence of an esophageal motility disorder was not significantly different between the two groups. These findings suggest upper gastrointestinal hypersensitivity in the patients whose symptoms were reproduced. Edrophonium provocative testing might be useful for evaluating upper gastrointestinal hypersensitivity in patients with NUD.