Involvement of midgastric transverse band in gastric emptying delay of functional dyspepsia

Midgastric transverse band (MTB) was first observed over 100 years ago, after that many researchers worked on the subject postulated its physiologic role and the role in gastrointestinal diseases, but its function remains unclear. With progress of imaging methods, the nature of MTB is unveiling. In this study we investigated the effect of MTB on the gastric emptying delay in functional dyspepsia (FD) and explored the mechanism.

A total of 60 patients with FD and 65 age- and sex-matched healthy people who served as controls were studied. With (99m)Tc-DTPA labeled semi-solid fat-parched flour served as test meal, gastric emptying was examined in all subjects by using single photon emission computed tomography. Test meal was designated as general (60 g fat-parched flour) or large (80 g fat-parched flour) meal. Stomach was divided into proximal and distal parts by MTB. Half gastric emptying time, areas of different gastric parts, intragastric food distribution and MTB width were tested with in given times.

Patients with FD showed a delayed gastric emptying and increased intragastric residue. Global and regional gastric emptying velocity was decreased. The areas of distal stomach and MTB were significantly greater in the FD patients than in the controls. Throughout the whole test period a distal stomach-dominated food distribution was shown. Those who took a large meal had longer half gastric emptying time and greater MTB area than those who took a general meal.

Gastric emptying delay is related to enlarged MTB area. Some dyspeptic symptoms may be induced by abnormal distribution and increased retention of food in distal stomach. MTB, being like atria-ventricular valve that controls blood flow in heart, regulates transport, distribution, and emptying of food in the stomach.