Cold Sensation and Gastric Accommodation in Functional Dyspepsia: An Exploratory Study of Autonomic Function

Background: Functional dyspepsia (FD) is a heterogeneous disorder characterized by impaired gastric accommodation and autonomic dysfunction as key pathophysiological features. Cold sensation (Hie), a commonly recognized subjective bodily sensation in East Asia, reflects autonomic instability. However, its association with gastric accommodation in FD remains unclear. Methods: This single-center prospective observational study enrolled healthy volunteers and patients with FD. Cold sensation was assessed using a validated questionnaire. Gastric accommodation was evaluated using a standardized nutrient drink test, with drinking time as indices of postprandial tolerance. Autonomic nervous system activity was examined using heart rate variability during the test. Results: Patients with FD had significantly shorter drinking times and lower completion rates than the healthy volunteers. In the combined cohort, cold sensation showed a weak inverse association with drinking time; however, this relationship did not reach statistical significance. In multivariable analysis adjusting for FD status and medication use, cold sensation was not independently associated with drinking time. Cold sensation was significantly inversely correlated with baseline coefficient of variation of R–R intervals, reflecting overall autonomic nervous system activity, but was not associated with nutrient load–induced autonomic responses. Conclusion: Cold sensation was more prevalent in patients with FD and was associated with reduced baseline autonomic activity. However, its association with gastric accommodation was attenuated after accounting for FD status, suggesting that cold sensation may represent a disease-related phenotype rather than an independent determinant of postprandial tolerance.