The water load test: observations from healthy controls and patients with functional dyspepsia

Gastric sensation and accommodation are studied by barostat, but this is invasive. The drink test is noninvasive and may provide similar information. We evaluated relationships between drink test, gastric function, symptoms, and psychiatric distress. Controls ( 73) and functional dyspeptics ( FD) (92) were studied using a 5-min water load test (WL5), gastric emptying, and electrogastrography ( EGG). Symptoms, quality of life, and psychiatric distress were measured using standardized measures. Controls underwent test-retest of WL5 and comparison of WL5 with 100 ml/min water-based drink test (WL100) or nutrient drink. Controls, FD, and gastroparetics estimated drinking capacity before WL5 using a visual analog scale. WL5 correlated with WL100 (r = 0.7929) but not nutrient drink test (r = 0.1995). WL5 was significantly less in FD than controls, and abnormal WL5 was seen in 46%. In FD, volume to fullness inversely correlated with symptom severity (r = -0.29; P = 0.0154) and WL5 produced more symptoms, particularly nausea. Gastric function was not different between FD with normal or abnormal WL5. Symptoms and psychiatric distress were similar between normal and abnormal WL5 groups, but the abnormal group had significantly poorer quality of life. Controls and gastroparetics had good correlation of estimated and ingested volumes, but FD did not. Versus FD with normal WL5 capacity, FD with impaired drinking capacity have normal gastric function and similar symptoms but poorer quality of life. FD are less able to predict drinking capacity. These data suggest that WL5 identifies FD with intact gastric function but abnormal visceral perception.