Issn Print: 0277-2116
Publication Date: 1996/05/01
58 GASTRIC ELECTRICAL ABNORMALITIES ARE DETECTED IN SEVERE GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD).
S. Cucchiara; G. Salvia; O. Borrelli; E Ciccimarra; R. Minella; M. Emiliano; A. Ciccarelli
Excerpt
Gastric dysmotility and delayed gastric emptying (GE) are regarded as pathogenetic components of GORD. As gastric motility is related to electrical activity (EA) of the smooth muscle cells, we measured simultaneously EA and GE by electrogastrography (EGG) and antral ultrasound, respectively, in 42 patients (pts) with GORD (median age: 7.6 yrs, range: 3-13 yrs). GORD was moderate in 20 pts and severe in 22 on the basis of pH test, endoscopy and clinical course. EGG was recorded during fasting and fed states by placing two pairs of Ag-AgCl electrodes on the epigastric skin; signals were analysed by fast Fourier transformation. The following EGG variables were measured: 1)% gastric dysrhythmias; 2) fed/fasting dominant power (power ratio); 3) fed/fasting instability coefficient of the dominant frequency (DFIC): Dysrhythmias were defined as tachygastria (frequency > 4 cpm or 0.066 Hz), bradygastria (frequency < 2 cpm or 0.033 Hz), with absence of normal gastric rhythm (2-4 cpm) and lasting at least 2 minutes. Results: severe GORD pts had a more prolonged GE time of a mixed solid-liquid meal (minutes) (235; 180-270) as compared to moderate GORD (195; 150-240; p<0.05) and controls (150;110-180; p<0.01). EGG analysis (mean±SD) is reported as follows: Table
Conclusions: fed gastric electrical abnormalities consisting of reduced amplitude and increased variability of the electrical dominant frequency are detected in pts with severe GORD and are associated with delayed gastric emptying. We suggest that gastric electrical dysrhythmias are a potential component in the pathogenesis of GORD.
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