Digestive, cognitive and hedonic responses to a meal C. MALAGELADA,* A. ACCARINO,* L. MOLNE,* S. MENDEZ,* E. CAMPOS, † A. GONZALEZ, † J. R. MALAGELADA* & F. AZPIROZ* *Digestive System Research Unit, University Hospital Vall d’Hebron, Centro de Investigaci on Biom edica en Red de Enfermedades Hep aticas y Digestivas (Ciberehd), Departament de Medicina, Universitat Aut onoma de Barcelona, Bellaterra, Cerdanyola del Vall es, Spain †Gallina Blanca Star Group, Hospitalet de Llobregat, Barcelona, Spain Key Messages • The physiological response to a meal includes a hedonic dimension involving pleasant digestive sensation. • The aim was to evaluate the hedonic response to a meal in conjunction with the digestive (gastric accommodation) and cognitive (conscious sensation) responses. • The responses to both an active and an inert meal, were evaluated in a group of 42 healthy subjects in 4 experimental conditions, two when they were hungry and predisposed to eating (basal fasting conditions) and two during experimentally induced fullness sensation. • Both the active and inert meals produced a conscious sensation of epigastric fullness, however, only with the active meal, this conscious sensation had a pleasant dimension. • Contrarily to the inert meal, the active meal was able to reverse the discomfort produced by the experimentally induced fullness. Abstract Background Gut dysfunctions may be associated to digestive symptoms. We hypothesized that the gut can also originate pleasant sensations, and wished to demonstrate the hedonic component of the digestive response to a meal. Methods Healthy subjects (n = 42) were evaluated during basal fasting conditions and during experimentally induced fullness sensation (either by gastric distension or duodenal nutrient infusion). In each set of studies, a 240 mL test meal (12 kcal broth) and water, as inert control meal, were administered on separate days in a randomized, cross- over design. Gastric accommodation, the cognitive response and the hedonic dimension (both by 10 score scales) were measured 9 min before and 60 min after the meal. Key Results In basal conditions, the test meal induced a significantly greater gastric relaxation than the control meal (166  28 mL isotonic volume increase 67  14 mL; p = 0.002). Both meals induced epigastric fullness (3.8  0.7 score and 3.2  0.8 score, respectively; p = 0.740), but contrary to the inert meal, with the active meal this conscious sensation had a pleasant dimension (digestive comfort increase by 1.3  0.6 score with active meal vs 1.1  0.6 decrease with inert meal; p = 0.015). Experimentally induced fullness was associated to a decrease in digestive well-being or abdominal discomfort, which improved only after the active meal but not the inert meal. Conclusions & Inferences When appropriate condi- tions are met, the response to a meal includes a hedonic dimension involving pleasant sensation of digestive well-being. Keywords gastric accommodation, gastric distension, hedonic response, intestinal nutrients, meal ingestion, postprandial sensations. INTRODUCTION Over the immediate past decades, visceral sensitiv- ity has been extensively investigated, particularly in Address for Correspondence Fernando Azpiroz, MD, Digestive System Research Unit, Hospital General Vall d’Hebron, Barcelona 08035, Spain. Tel: (34) 93 274 62 22; fax: (34) 93 489 44 56; e-mail: azpiroz.fernando@gmail.com Received: 10 September 2014 Accepted for publication: 3 December 2014 © 2015 John Wiley & Sons Ltd 389 Neurogastroenterol Motil (2015) 27, 389–396 doi: 10.1111/nmo.12504 Neurogastroenterology & Motility