BACKGROUND As the gastric emptying time delay of patients with functional dyspepsia is not correlated with the severity of dyspepsia complaints, we investigated the pattern of intragastric distribution of a meal with an ultrasonographic method in different groups of dyspeptic patients. METHODS The final gastric emptying time and the postprandial variations of the cross-sectional area of the gastric antrum were measured ultrasonographically, and dyspeptic symptoms were scored in 41 patients with dysmotility-like dyspepsia, of whom 31 did not have digestive or systemic diseases known to affect gut motility (group A) and 10 had scleroderma involving the upper gut (group B). Twelve normal subjects were examined as a control group. RESULTS The final emptying times of groups A and B did not differ significantly but were both significantly longer than that of controls, whereas the antral area at 60 min showed a significantly greater increase in patients of group A than in group B. The symptom score showed significantly more severe dyspepsia in group A than in group B. CONCLUSIONS The fact that the postprandial antral distention was more marked in the dyspeptic patients with more severe symptoms suggests that this motor pattern could play a more important role in the genesis of dyspeptic symptoms than the delay in gastric emptying time, which was similar in the two groups.