Postprandial fullness correlates with rapid inflow of gastric content into duodenum but not with chronic gastritis

Abstract

Background: The aim of this study is evaluating the correlation of postprandial fullness with chronic gastritis or rapid inflow of gastric content into duodenum, based on double-contrast barium X-ray imaging.

Methods: 253 healthy subjects who underwent upper gastrointestinal barium X-ray examination were analyzed. Chronic gastritis was judged from mucosal atrophy and hypertrophic thickened folds on barium X-ray images. For the gastric excretion, the tips of barium flow on the single-contrast frontal barium X-ray images of the stomach were classified into four categories; V type (all the barium remained in the stomach), V-H type (some barium had flowed into the duodenum but the tip of barium remained in the proximal half of the duodenal bulb), H-V type (some barium had flowed into the duodenum and the tip of barium was in the distal half of duodenal the bulb, but no barium was observed in the descending part of the duodenum), and H type (some barium had flowed into the descending part of the duodenum). The chi-square test and Cochran-Mantel-Haenzel test were used for evaluation.

Results: Chronic gastritis was observed in 72 subjects, among which 21 subjects (29.2%) presented with postprandial fullness. For the remaining 181 subjects without chronic gastritis, 53 subjects (29.3%) complained of postprandial fullness. There is no significant correlation between chronic gastritis and postprandial fullness (p = 0.973). For the rapid flow of gastric content into duodenum, all the 253 subjects comprised 136 subjects with V type (in the stomach), 40 subjects with V-H type (in the proximal half of the duodenal bulb), 21 subjects with H-V type (in the distal half of the duodenal bulb), and 56 subjects with H type (in the descending part of the duodenum). Postprandial fullness was present in 30 subjects with V type (22.1%), 9 subjects with V-H type (22.5%), 8 subjects with H-V type (38.1%), and 27 subjects with H type (48.2%). There is a distinct correlation between postprandial fullness and gastric barium excretion on barium X-ray imaging (p = 0.002).

Conclusions: Bothersome postprandial fullness correlates with rapid inflow of gastric content into duodenum, but not with chronic gastritis.

Figure 1

The typical two types of chronic gastritis observed in the double-contrast barium X-ray images. (A) Atrophic gastritis with enlarged areae gastricae. (B) Hypertrophic gastritis with thickened folds on the greater curvature.

Figure 2

The degrees of gastric barium excretion based on the tip of barium flow in a single-contrast frontal view of the stomach in the standing position. (A) V type (in the stomach). (B) V-H type (in the proximal half of the duodenal bulb). (C) H-V type (in the distal half of the duodenal bulb). (D) H type (in the descending part of the duodenum).