BACKGROUND: Functional dyspepsia (FD) is a complex symptom. Currently there are multiple therapeutic options that are used for the management of these patients; however, FD therapies are based on symptomatic control and do not address the pathophysiological pathways involved in its development. The duodenum has been proposed as a key site to understand the complex pathophysiology involved in FD.
OBJECTIVE: The aim of the study is to determine duodenal eosinophilia in patients with FD and establish the clinical-pathological correlation with the cardinal symptoms of dyspepsia.
METHODS: Case-control study. Patients older than 18 years with dyspepsia according to the Rome IV criteria, and upper gastrointestinal endoscopy normal (FD group).Patients with iron deficiency anemia and chronic diarrhea (control group). Biopsies were taken in the stomach, duodenal bulb and second portion of duodenum. A sample size of 140 patients (70 patients in the FD group and 70 patients in the control group) was calculated. The collected information was described and analyzed by conventional statistical techniques.
RESULTS: 243 patients were recruited. 84 patients were included in the FD group and 84 patients in the control group. 135 patients were women (80.3%). The mean age was 53.6 years (SD 14.9). Duodenal eosinophilia was found with significant difference in patients with early satiety (p=0.01). There was no difference in patients with postprandial fullness (p=0.63), epigastric pain or burning (p=0.26), gastroesophageal reflux symptoms (p=0.13), allergy and food intolerance (p=0.42) and smoking (p=0.28). There was no relationship between duodenal mastocytosis and early satiety (p=0.98), postprandial fullness (p=0.78), and epigastric pain or burning (p=0.82).
CONCLUSIONS: Duodenal eosinophilia was similar in FD and controls. In subgroup analysis, duodenal eosinophilia occurs in patients with early satiety.

Increasing portion sizes over the last 30 years are considered to be one of the factors underlying overconsumption. Past research on the drivers of portion selection for foods showed that larger portions are selected for foods delivering low expected satiation. However, the respective contribution of expected satiation vs. two other potential drivers of portion size selection, i.e. perceived healthfulness and expected tastiness, has never been explored. In this study, we conjointly explored the role of expected satiation, perceived healthfulness and expected tastiness when selecting portions within a range of six commercial pizzas varying in their toppings and brands. For each product, 63 pizza consumers selected a portion size that would satisfy them for lunch and scored their expected satiation, perceived healthfulness and expected tastiness. As six participants selected an entire pizza as ideal portion independently of topping or brand, their data sets were not considered in the data analyses completed on responses from 57 participants. Hierarchical multiple regression analyses showed that portion size variance was predicted by perceived healthiness and expected tastiness variables. Two sub-groups of participants with different portion size patterns across pizzas were identified through post-hoc exploratory analysis. The explanatory power of the regression model was significantly improved by adding interaction terms between sub-group and expected satiation variables and between sub-group and perceived healthfulness variables to the model. Analysis at a sub-group level showed either positive or negative association between portion size and expected satiation depending on sub-groups. For one group, portion size selection was more health-driven and for the other, more hedonic-driven. These results showed that even when considering a well-liked product category, perceived healthfulness can be an important factor influencing portion size decision.

BACKGROUND: Mesenteric lymphangioma are rare tumours. They usually present early on in life, if congenital, or soon after trauma. The usual sites of presentation of lymphangiomas are in the neck, and axillae. In the abdomen they are more common in the mesentery, primarily of the ileum, or retroperitoneal.
OBJECTIVE: A rare case is presented of a mesenteric lymphangioma.
METHODS: It involves an elderly African-American male, many years after trauma, and characterised with early satiety, causing weight loss, but without gastric outlet obstruction or vomiting. Its diagnosis, management and review of literature are presented.
CONCLUSIONS: Mesenteric cysts are rare tumours that should be included as differential diagnosis in elderly patients with a history of previous abdominal trauma.

Research in animal models has implicated N-methyl-D-aspartate (NMDA) receptors (NMDARs) in the control of food intake. Until now, these findings have been not replicated in humans. Here we describe a 22-year-old woman with anti-NMDAR encephalitis and no prior neurological or psychiatric history. Her clinical course was marked by successive eating disorders: anorexia followed by hyperphagia. We propose that, much as they do in other animals, NMDARs in humans interact with the neuroendocrine, homeostatic, and reward systems controlling food intake in the central and peripheral nervous system structures related to feeding and satiety.

OBJECTIVE: To review the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of postinfectious gastroparesis (PIGP).
METHODS: Review of literature using Medscape, the Internet, and PubMed. The following search terms were used: gastroparesis, postinfectious gastroparesis, postviral gastroparesis, and idiopathic gastroparesis. There was no limitation placed on publication year. Only articles in English were used.
CONCLUSIONS: PIGP is a rare illness that can affect all ages and both genders, although more prominent in middle-aged women. It is defined as delayed gastric emptying after an acute self-limited viral infection in the absence of mechanical obstruction. Limited research is available on PIGP. It is a complicated disorder with an unclear pathogenesis and narrow treatment options, therefore affecting the patient\'s quality of life significantly. Fortunately, the prognosis of PIGP is good, although in some instances it can take years to recover completely.
CONCLUSIONS: There is a huge lack of awareness of PIGP among primary care providers (PCPs). The importance of this illness is greatly underestimated. Educating PCPs about PIGP leads to quicker referrals and therefore faster treatment for patients, which in turn improves their health and quality of life, and thereby decreases healthcare costs as well.

Satiety, the physiologic processes that combine to bring about the cessation of a meal, is controlled in part by intestinal peptide secretion. The effects of cholecystokinin, glucagon-like peptide I, peptide YY, and apolipoprotein A-IV are described.

Sarcoidosis is a systemic granulomatous disease of unknown etiology that is characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) tract involvement in sarcoidosis is rare. Gastric sarcoidosis, particularly involving the antrum, affects approximately 10% of patients with systemic disease. GI sarcoidosis commonly occurs subclinically, with clinical manifestations present in only 0.1 to 0.9% of patients with the disease. This is a rare case report of an individual with symptomatic gastric sarcoidosis. The patient presented with weight loss, nausea, and early satiety. An EGD and colonoscopy were performed and were grossly normal. However, biopsies of the gastric antrum revealed noncaseating granulomatous inflammation involving the gastric mucosa. Corticosteroid therapy was started and the symptoms abated almost immediately. We also offer a review of the literature.

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Two promising techniques for smoking reduction, sensory deprivation and stimulus satiation, were applied in combination to five smokers. All were successful initially in achieving abstinence and four ultimately in maintaning abstinence. The issue of possible side-effects is worth considering. Quitting per se and both satiation and sensory deprivation may be stressful and as a result may potentially produce negative side effects. The observation of positive side-effects in these cases balances this possibility to some extent.