Maximum tolerated volume in drinking tests with water and a nutritional beverage for the diagnosis of functional dyspepsia

Abstract

Aim: Recently, drinking load tests with water or nutritional beverages have been proposed as diagnostic tools for functional dyspepsia (FD), therefore we sought to reproduce if these tests can discriminate between FD patients and controls in a Mexican population. Methods: Twenty FD-Rome II patients were matched by age and gender with 20 healthy controls. All underwent both drinking tests at a 15 mL/min rate, randomly, 7 d apart. Every 5 min within each test, four symptoms were evaluated (satiety, bloating, nausea and pain) by Likert scales. Maximum tolerated volume (MTV) was defined as the ingested volume when a score of 5 was reached for any symptom or when the test had to be stopped because the patients could not tolerate more volume. Sensitivity and specificity were analyzed. Results: FD patients had higher symptom scores for both tests compared to controls (water: t = 4.1, P = 0.001 <0.01; Nutren®: t = 5.2, P = 0.001<0.01). The MTV for water and Nutren® were significantly lower in FD (water: 1014±288 vs 1749±275 mL; t = 7.9, P = 0.001<0.01; Nutren®: 652±168 vs 1278±286 mL; t = 6.71 P = 0.001 <0.01). With the volume tolerated by the controls, the percentile 10 was determined as the lower limit for tolerance. Sensitivity and specificity were 0.90, 0.95 for water and 0.95, 0.95 for Nutren® tests. Conclusion: A drinking test with water or a nutritional beverage can discriminate between FD patients and healthy subjects in Mexico, with high sensitivity and specificity. These tests could be used as objective, noninvasive, and safe diagnostic approaches for FD patients. © 2005 The WJG Press and Elsevier Inc. All rights reserved.