Postcibal secretory and symptomatic responses to increased intragastric pressure

Abstract The mechanical and secretory factors in the stomach that may be implicated in the production of symptoms are still poorly understood. To determine whether symptoms in response to postcibal gastric distention are associated with increased acid secretion, the relationship between symptoms, acid secretion and intragastric pressure in healthy subjects was investigated. Perception (by a 0–6 score questionnaire) and the gastric secretory response to a glucose test meal (by intragastric titration) was quantified either at low (2 mmHg) or at high (8 mmHg) intragastric pressure levels, maintained by feedback regulation of the air volume within a gastric bag using an electronic barostat. Low intragastric pressure produced a small gastric expansion (87 ± 26 ml; mean ± SE) that was largely unperceived (score 0.7 ± 0.5). High intragastric pressure did not increase acid secretion (15 ± 3 mEq h^-1 vs 16 ± 3 mEq h^-1 at low pressure), but produced symptomatic perception (score 2.5 ± 0.7) related to a marked gastric expansion (521 ± 92 ml; P < 0.05 vs low pressure for both). It was concluded that postcibal gastric hypertension induces symptoms without affecting the gastric acid secretory response to the meal.