were divided into three groups of the same size (group A: -33%, group B: 33-66%, groupC: 66-100%). Thus, including those who had concentrations lower than the limit of detection(control group), all the subjects were divided into four groups. For atrophic gastritis andintestinal metaplasia, the odds that the control group would develop such diseases accordingto H. pylori infection was set as 1, and the odds ratios (ORs) and 95% CIs of the threegroups were obtained, by which their differences from the control group were estimated.[Results] Reflux of bile acid was recognized in 64.3% (189 of 294 cases). There was norelation between refluxed bile acid and H. pylori infection. H. pylori infection showedrelevance to glandular atrophy (OR3.3, 95%CI 1.6-6.8), but showed no relevance to intestinalmetaplasia (OR1.1, 95%CI 0.6-2.0). Regarding atrophic gastritis, there was no significantrelation between control group and group A, B, and C, both for H. pylori positive andnegative cases. OR values for intestinal metaplasia withoutH. pylori infectionwere significantlyhigh in group C compared with the control group (OR 2.4, 95% CI 1.1-5.6) [Conclusion]Reflux bile acid did not influence gastric mucosal atrophy. On the other hand, reflux ofhigh-concentration bile acid influenced intestinal metaplasia.

Tu2067

Relationship and Associated Factors Between Gastric Emptying and DyspepticSymptoms in Chinese Patients With Functional DyspepsiaNijiao Li, Shunkun Yao, Yanli Zhang, Chun Gao

Objective: Many studies have shown that part of patients with functional dyspepsia(FD)had abnormal gastric emptying. But the factor associated with abnormal gastric emptyinghas not been clarified. Our study was aimed to show the association between abnormalgastric emptying and dyspeptic symptoms, and find the possible factors associated withgastric emptying in patients with functional dyspepsia. Method: Thirty-two FD patients wereexamined,including 15 men and 17 women. The mean age was 41±13.54 years old.Sevendyspepsia symptoms were recorded, including postprandial epigastric fullness, epigastricpain, epigastric burning, early satiety, belching, nausea and vomiting. Scintigraphy was usedto assess gastric emptying after 99Tc-labeled low fat meal.Parameters were assessed bystandards which American Neurogastroenterology and Motility Society had recommended,including 1h residual rate (Retention1h%), 2h residual rate (Retention2h%), half-emptyingtime (T1/2). Resting heart rate in sitting position were measured twice right after test andthe averages were calculated. Median heart rate(70bpm)was taken as a cutoff to transformthem into Binary variables for Logistic regression analysis. Pearson and Spearman rankcorrelation and non-conditional Logistic regression analysis were used for statistics. Results:Of the 32 patients,13 were diagnosed with postprandial distress syndrome(PDS)and 19 withPDS and epgastric pain syndrome(EPS)(PDS&EPS). Eight patients (25%)had delayed T1/2and 7 patients (23.33%) had increased Retention2h%.All the Retention1h% were within thenormal range. There were no significant difference between PDS group and PDS & EPSgroup in Retention2h%, Retention1h% and T1/2. Nausea was more common in increasedRetention2h% group than that in normal Retention2h% group(P=0.003), which was associ-ated with Retention2h%(R=0.527, P=0.002)and T1/2(R=0.381,P=0.032).Logistic regressionanalysis indicated that nausea was an independent factor for increased Retention2h%(OR=2.267, P=0.119). Heart rate was higher in increased Retention2h% group than that in normalRetention2h% group(P=0.031), the similar result was found in prolonged T1/2 group andnormal T1/2 group(P=0.022). Higher heart rate was associated with Retention2h%(R=0.448,P=0.01)and T1/2(R=0.423, P=0.016). After controlling gender, age,BMI and othersymptoms condition,higher heart rate (>70bpm) is an independent factor for increasedRetention2h%(OR=12.378, P=0.042) and prolonged T1/2 (OR=8.18, P=0.072). Conclusion:Higher heart rate and nausea were associated with gastric emptying in patients with functionaldyspepsia.Higher resting heart rate may be an independent factor for delayed gastric empty-ing, which indicates higher sympathetic activity in these patients.

Tu2068

Characterization of the Gastric Accommodation Process by a 13C-AcetateBreath Test: Effects of Gender and Body Mass Index in HealthRafael Tojo, Laura Nieto, Enrique Dominguez-Munoz

Background: Gastric accommodation (GA) is a vagally mediated relaxation of the proximalstomach, providing the meal with a reservoir. Alteration in the GA process is a mayorpathogenic factor in functional dyspepsia. GA can be non-invasively measured by a 13C-acetate breath test (Tojo R et al, DDW 2010). The test is based on the hypothesis that twoliquid meals of different volumes and the same caloric load are emptied from the stomachat the same rate due to the GA process. Data about the influence of gender and body massindex (BMI) in the GA process are lacking. Aim: To assess the effect of gender and BMI onthe GA process in healthy asymptomatic subjects. Subjects and methods: An experimental,open-label, crossover study on 14 healthy volunteers (mean age 22.6 + 0.8 years), groupedby gender (7 men - 7 women), and BMI (8 normal weight (BMI 18-24.9), 6 overweight(BMI 25-29.9) was carried out. Gastric emptying of four different liquid test meals with acaloric load of 300 kCal each, and a volume of 200, 400, 600, and 800 ml, respectively,was measured by the 13C-acetate breath test in four different days one week apart. Breathsamples were collected at 15 min intervals for 180 min and analyzed by mass spectrometry.The half gastric emptying time (t1/2) for each meal, and the percentage of change in thet1/2 (delta %t1/2) between meals were calculated and compared by ANOVA. Results: Thegastric t1/2 for meals of 200, 400 and 600ml was similar in men and women (men:61.2+12.3min, 61.8+12.5min, 62+13min; women: 76.6+21.1min, 67.5+14.5min,71+13.1min, respectively), as well as in normal weight (64.8+12.8min, 60.1+11.3min,62.2+13.9min, respectively) and overweight (76.2+26.1min, 72.4+16.3min, 73.3+12.6min,respectively). The 800 ml meal emptied faster in each study group (49.9+9.6min in men,60.6+12.4min in women, 52.7+10.2min in normal weight, 60.5+14min in overweight,p<0.05 compared to lower volume meals), without differences between men-women, normalweight-overweight. Based on these results, 600 and 200ml test meals were the suitable tocompare for evaluation of GA. The delta %t1/2 between 600-200 ml meals did not varyamong men-women (2.3+14.8min, 1+39.4min, respectively), and normal weight-overweight(-2+24.7min, 5.4+45min, respectively). Conclusions: The GA process in health, as measuredby 13C-acetate breath test, is not influenced by gender or BMI. This allows for more variability

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when matching groups in controlled studies. Meals of 800ml volume exceed the physiologicalGA capacity, regardless of gender and BMI.

Tu2069

Itopride Compared to Placebo in Functional Dyspepsia: A Meta-AnalysisErnest Abegail Dela Cruz, Queenie Ngalob, Janus Ong

BACKGROUND Despite a number of prokinetic agents already available, the treatment forfunctional dyspepsia (FD) remains a problem to clinicians. With the withdrawal of widelystudied drug, cisapride from the market, newer agents are being introduced for FD. Itopride,a dopamine antagonist, is one such drug that has been evaluated in the treatment of FD.OBJECTIVE To examine the efficacy of itopride compared to placebo in patients with FD.METHODS A literature search was conducted using PubMEd, MEDLINE, and Cochranedatabases of randomized controlled trials evaluating the efficacy of Itopride. Authors ofpublished trials were emailed to inquire if they had data that is yet unpublished. Meta-analysis was conducted using fixed effects model. RESULTS Of the 5 papers identified inthe literature search, three studies comparing itopride to placebo where of sufficient qualityto be included in the analysis. Using the Global Patient Assessment of Efficacy, when itopridewas taken 100mg tab 3x a day for 8 weeks compared to placebo, results showed that therewas a trend in favor of itopride but failed to reach significance (RR 0.9, 95% CI 0.80 to1.02; P=0.07). Sensitivity analysis was done by removing the study done by Holtmann dueto differences in the population involved, which eliminated heterogeneity. In that study,absence of H. pylori infection and heartburn among patients were not excluded. After thesensitivity analysis, results still show a trend towards itopride (RR 0.97, 95% CI 0.84 to1.12). However, comparing the Leeds Dyspepsia Questionnaire, results showed that Itopride(100mg tablet taken 3x a day) is effective in improving symptoms of functional dyspepsia(Mean difference - 1.67, 95% CI - 1.82, -1.52). CONCLUSIONS Despite a trend showingefficacy of itopride in functional dyspepsia, there is still a lack of evidence that would showa conclusive benefit of itopride. Further studies with well-structured, placebo controlledtrials are recommended to show the true benefit of itopride in functional dyspepsia.

Tu2070

Risk Factors Associated With Functional Dyspepsia in Japanese AdultsYasuhiro Fujiwara, Makiko Kaji, Yukie Kohata, Hirokazu Yamagami, Tetsuya Tanigawa,Kenji Watanabe, Kazunari Tominaga, Toshio Watanabe, Tetsuo Arakawa

OBJECTIVE: Functional dyspepsia (FD) is one of the most common gastrointestinal (GI)disorders. According to the Rome III criteria, FD is divided 2 distinct subtypes, namely,postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Although manystudies have investigated the epidemiology of FD, there have been a few studies that haveused the newly defined criteria for detection of the 2 aforementioned subtypes. The aim ofthe present study was to examine the prevalence of FD including PDS and EPS, and theirclinical characteristics in Japanese adults. METHODS: We performed a cross-sectional studyof Japanese workers who had undergone a routine health check-up, and asked to completea self-report questionnaire regarding age, gender, height, weight, medications for currentdiseases, drugs in regular use, and key questions based on Rome III for FD diagnosis. Logisticregression model was used to calculate the odds ratio (OR) at 95% confidence intervals(CI). RESULTS: Of the 2281 eligible subjects, FD was detected in 269 (11.8%) subjects,and PDS was found to be more frequent (82%) than EPS (24%). Fifteen (5.6%) subjects of269 FD had both PDS and EPS. Female gender (OR, 1.49; 95% CI, 1.08-2.04), smokinghabits (OR, 1.05; 95% CI, 1.12-2.01), and drinking habits (OR, 1.51; 95% CI, 1.12-2.04)were significantly associated with FD, while high body mass index (BMI) defined as ≥25kg/m2 (OR, 0.62; 95% CI, 0.46-0.82) was inversely associated with FD. Analysis of the FDsubtypes showed that high BMI, smoking habits, and drinking habits were associated withPDS, while only female gender was associated with EPS. CONCLUSION: Functional dyspep-sia was commonly observed in Japanese adults, and PDS was more frequent than EPS.Female gender, low BMI, smoking habits, and drinking habits were associated with FD. Thefactors associated with PDS and EPS were different.

Tu2071

Intragastric Pressure (IGP) During Intragastric Nutrient Drink Infusion: AMethod to Objectively Discriminate Functional Dyspeptic (FD) Patients WithImpaired Nutrient Tolerance and/or Gastric AccommodationPieter Janssen, Jan F. Tack

Introduction: To date the barostat and the drinking test are considered the golden standardto assess gastric accommodation and nutrient tolerance respectively in FD patients. Thebarostat is however considered unphysiological and bothersome while the drinking testmight be flawed by taste perception and subjective anticipation of symptoms. We set outto investigate whether we could objectively discriminate FD patients from healthy volunteers(HV) by measuring the IGP during intragastric nutrient drink infusion until full satiety.Methods: 8 patients with unexplained postprandial dyspeptic symptoms that were selectedfrom an outpatient clinic pool were compared with 14 HV. A manometer and an infusion

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