Influence of Experimentally Induced Anxiety on Gastric Sensorimotor Function in Humans

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 129; no. 5; pp. 1437 - 1444
• Main Authors: Geeraerts, Brecht, Vandenberghe, Joris, Van Oudenhove, Lukas, Gregory, Lloyd J., Aziz, Quasim, DuPont, Patrick, Demyttenaere, Koen, Janssens, Jozef, Tack, Jan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2005
• Subjects: Adult; Anxiety - physiopathology; Dyspepsia - etiology; Dyspepsia - physiopathology; Dyspepsia - psychology; Eating; Fasting - physiology; Fasting - psychology; Female; Gastric Emptying - physiology; Humans; Male; Motor Neurons - physiology; Neurons, Afferent - physiology; Pressure; Stomach - innervation; Stomach - physiology; MDP; VAS; STAI
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2005.08.020

Background & Aims: Unexplained dyspeptic symptoms are associated with changes in gastric sensorimotor function and several psychopathologic dimensions, including anxiety. It is unclear whether this reflects common predisposition or a causal relationship. The aim of this study was to investigate whether experimentally induced anxiety would alter gastric sensorimotor function in health. Methods: Fourteen subjects underwent a gastric barostat study to assess gastric sensitivity and accommodation. Eighteen subjects underwent a 10-minute satiety drinking test (30 mL/min) with registration of epigastric symptoms on a visual analogue scale (VAS) at 2-minute intervals. Emotional context was modulated for 10 minutes at the start of each experiment by combined projection of validated facial expressions and an audiotape recalling a neutral or an anxious autobiographical experience. Anxiety levels were assessed using a VAS and the Spielberger State-Trait Anxiety Inventory (STAI). Results: VAS and STAI scores confirmed efficacy of anxiety induction. During the anxiety condition, gastric compliance was significantly decreased (57 ± 5 vs 40 ± 5 mL/mm Hg; P < .01). Intraballoon pressures inducing discomfort during gastric distention were not altered, but the corresponding volume (630 ± 47 vs 489 ± 39 mL; P < .005) was significantly lower. Meal-induced relaxation was inhibited during the anxiety condition and this persisted for the 60-minute measurement (157 ± 29 vs 100 ± 24 mL; P < .05). During the satiety drinking test, the anxiety condition was associated with significantly higher scores for satiety, fullness, and bloating. Conclusions: Experimentally induced anxiety alters gastric sensorimotor function, suggesting that psychological factors may play a causal role in the pathogenesis of some dyspeptic symptoms and mechanisms.