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. 2025 Jun;70(6):2054-2061.
doi: 10.1007/s10620-025-08973-5. Epub 2025 Mar 11.

Empty Stomach Sensation and Bothersome Hunger Sensation: Two Relevant Clinical Manifestations in Patients with Dyspepsia

Francisco Alejandro Félix Téllez  1 , José María Remes Troche  1 , Ana Luisa Mateos Viramontes  2 , Alex René Sandoval Avilés  2 , Héctor Ricardo Ordaz Álvarez  1 , José Antonio Velarde Ruiz Velasco  3 , Ángel Ricardo Flores Rendon  4
Affiliations

Empty Stomach Sensation and Bothersome Hunger Sensation: Two Relevant Clinical Manifestations in Patients with Dyspepsia

Francisco Alejandro Félix Téllez et al. Dig Dis Sci. 2025 Jun.

Abstract

Background: Dyspepsia, characterized by symptoms in the gastroduodenal region, poses diagnostic challenges despite Rome IV criteria.

Aim: This study aimed to investigate the prevalence of two underreported symptoms, Empty Stomach Sensation and Bothersome Hunger Sensation, in dyspeptic patients, and their association with the disorder of gut-brain interaction.

Methods: A cross-sectional study surveyed 1,211 individuals in northwest Mexico, assessing dyspeptic symptoms with pictograms and a 7-point Likert scale. Logistic regression analyzed associations between dyspepsia, Empty Stomach Sensation, and Bothersome Hunger Sensation.

Results: Dyspepsia prevalence was 39.1%, being overlap syndrome the most common (42.7%) phenotypic presentation. Empty Stomach Sensation prevalence in dyspeptic patients was 43.8% versus 12.6% in non-dyspeptics (p < 0.001). Bothersome Hunger Sensation prevalence in dyspeptics was 25.4% compared to 5.6% in non-dyspeptics (p < 0.001). Both symptoms were associated with epigastric pain syndrome, postprandial distress syndrome, overlap syndrome, anxiety disorders and other gastroduodenal symptoms.

Conclusions: Empty Stomach Sensation and Bothersome Hunger Sensation, though prevalent in dyspeptic patients, are often overlooked. Strengths of this study include its large sample size and comprehensive assessment of symptoms. Limitations include the lack of diagnostic endoscopy and long-term follow-up. Future research should explore the underlying mechanisms of these symptoms and their implications for clinical management.

Keywords: Anxiety; Disorders of gut-brain interaction; Functional dyspepsia; Hunger; Postprandial distress syndrome; Satiety.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflicts of interest to declare. Ethical approval: This study protocol was reviewed and approved by the ethics committee of the Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana, approval number IIMB-008–2017. Consent to participate: Informed consent was obtained verbally by the surveying physicians and written informed consent was provided on paper, following prior evaluation by the ethics committee of the Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana.

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