Diagnosis and treatment of neuromuscular disorders of the stomach

Koch, Kenneth L.

doi:10.1007/s11894-003-0070-2

Cited by 13 publications

(5 citation statements)

References 55 publications

(45 reference statements)

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“…Denervation is an accepted consequence of gastrectomy and may affect motor, exocrine, and endocrine functions of the entire gastrointestinal tract. Disruption of intrinsic neural integrity may result in disordered contractile activity of the reconstruction 17,24,25. Sarr and Kelly showed that extrinsic nerves were necessary for postprandial motor activity, and we might therefore assume that extrinsic neural integrity of the reconstructed intestine may be important for postprandial pouch function 26…”

Section: Discussionmentioning

confidence: 99%

J-pouch versus Roux-en-Y reconstruction after gastrectomy: functional assessment and quality of life (randomized trial)

Zonča¹,

Malý²,

Ihnát³

et al. 2016

OTT

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PurposeThe aim of this study was to evaluate the quality of life and functional emptying of J-pouch versus Roux-en-Y reconstruction after total gastrectomy for malignancy.MethodsThis study was designed as a prospective, nonblinded, randomized, parallel clinical trial (Trial Number: MN Ostrava, 200604). With informed consent, patients undergoing gastrectomy for malignancy were randomized to J-pouch or Roux-en-Y reconstruction. The time taken for a test semisolid meal labeled with 99mTc-sulfur colloid to exit the reconstructed parts was measured by dynamic scintigraphy 1 year after resection. Quality of life was measured using the Eypasch questionnaire at the same time as functional emptying assessment. This trial was investigator-initiated.ResultsIn all, 72 patients were included into the study. The time taken for the test meal to exit the postgastrectomy reconstruction was 16.5±10.0 minutes (mean ± standard deviation) in the Roux-en-Y group and 89.4±37.8 minutes in the “J-pouch” group; the difference was statistically significant (P<0.001). Emptying of the J-pouch appeared to be a linear decreasing function compared to the exponential pattern seen in the Roux-en-Y group. The quality of life measurement showed scores of 106±18.8 points (mean ± standard deviation) in the Roux-en-Y group compared to 122±22.5 points in the J-pouch group; the difference was statistically significant (P=0.0016). There were no important adverse events.ConclusionAfter total gastrectomy, a J-pouch reconstruction empties more slowly and is associated with higher quality of life compared to Roux-en-Y reconstruction. Whether these two observations have a direct causative link remains unanswered.

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Section: Discussionmentioning

confidence: 99%

J-pouch versus Roux-en-Y reconstruction after gastrectomy: functional assessment and quality of life (randomized trial)

Zonča¹,

Malý²,

Ihnát³

et al. 2016

OTT

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“…Patients with functional dyspepsia often exhibit gastric dysrhythmias [18], as do patients with other gastrointestinal diseases, such as gastroparesis (diabetic and idiopathic) [35]. These dysrhythmias are thought to contribute not only to symptoms of nausea but also to early satiety, fullness, bloating, and abdominal discomfort.…”

Section: Nausea and Gastric Dysrhythmiasmentioning

confidence: 99%

“…Patients with idiopathic and diabetic gastroparesis have poor fundic relaxation, and many have gastric dysrhythmias and gastroparesis [35,63]. These patients usually do not experience hunger, almost always feel full, and have early satiety.…”

Section: Effects Of Gastric Neuromuscular Dysfunction On Hunger and Smentioning

confidence: 99%

Sickness and satiety: Physiological mechanisms underlying perceptions of nausea and stomach fullness

Levine

2005

Curr Gastroenterol Rep

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The pathophysiology of nausea and the physiological mechanisms underlying perceptions of stomach emptiness and fullness are not clearly understood, but several potentially important factors have been identified. Gastric dysrhythmias are believed to contribute to the subjective experience of nausea and may also be involved with perceptions of stomach emptiness, hunger, and even dyspepsia symptoms like bloating and early satiety. Normal gastric neuromuscular function is more evident in the absence of nausea and is also thought to be related to feelings of satiety or comfortable stomach fullness. Autonomic and endocrine influences may also play a critical role in the pathophysiology of nausea and abnormal perceptions of stomach emptiness or fullness. Achieving a better understanding of the gastric neuromuscular and neurohormonal influences on perceptions arising from the viscera may prove invaluable in the development of novel treatments for such conditions as unexplained nausea, functional dyspepsia, and obesity.

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“…EGG is the recording of gastric electric activity on the upper abdominal surface and it is compounded by slow waves (SW) and spike bursts [ 8 ]. Slow waves are pacemaker activity generated and propagated through the network of interstitial cells of Cajal’s [ 9 ]. Spike bursts are rapid action potentials that only appear on the slow wave plateau during stomach contractions, and their energy is directly linked to the intensity of gastric contractions [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Slow waves are pacemaker activity generated and propagated through the network of interstitial cells of Cajal’s [ 9 ]. Spike bursts are rapid action potentials that only appear on the slow wave plateau during stomach contractions, and their energy is directly linked to the intensity of gastric contractions [ 9 ]. In healthy humans, the gastric SW dominant frequency is typically around 3 cycles per minute, originates in the upper corpus region and propagates towards the pylorus [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Vectorgastrogram: dynamic trajectory and recurrence quantification analysis to assess slow wave vector movement in healthy subjects

Prats-Boluda,

Martinez-de-Juan,

Nieto-del-Amor

et al. 2024

Phys Eng Sci Med

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Functional gastric disorders entail chronic or recurrent symptoms, high prevalence and a significant financial burden. These disorders do not always involve structural abnormalities and since they cannot be diagnosed by routine procedures, electrogastrography (EGG) has been proposed as a diagnostic alternative. However, the method still has not been transferred to clinical practice due to the difficulty of identifying gastric activity because of the low-frequency interference caused by skin–electrode contact potential in obtaining spatiotemporal information by simple procedures. This work attempted to robustly identify the gastric slow wave (SW) main components by applying multivariate variational mode decomposition (MVMD) to the multichannel EGG. Another aim was to obtain the 2D SW vectorgastrogram VGGSW from 4 electrodes perpendicularly arranged in a T-shape and analyse its dynamic trajectory and recurrence quantification (RQA) to assess slow wave vector movement in healthy subjects. The results revealed that MVMD can reliably identify the gastric SW, with detection rates over 91% in fasting postprandial subjects and a frequency instability of less than 5.3%, statistically increasing its amplitude and frequency after ingestion. The VGGSW dynamic trajectory showed a statistically higher predominance of vertical displacement after ingestion. RQA metrics (recurrence ratio, average length, entropy, and trapping time) showed a postprandial statistical increase, suggesting that gastric SW became more intense and coordinated with a less complex VGGSW and higher periodicity. The results support the VGGSW as a simple technique that can provide relevant information on the “global” spatial pattern of gastric slow wave propagation that could help diagnose gastric pathologies.

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Diagnosis and treatment of neuromuscular disorders of the stomach

Cited by 13 publications

References 55 publications

J-pouch versus Roux-en-Y reconstruction after gastrectomy: functional assessment and quality of life (randomized trial)

J-pouch versus Roux-en-Y reconstruction after gastrectomy: functional assessment and quality of life (randomized trial)

Sickness and satiety: Physiological mechanisms underlying perceptions of nausea and stomach fullness

Vectorgastrogram: dynamic trajectory and recurrence quantification analysis to assess slow wave vector movement in healthy subjects

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