Gastric Electrical Activity and Gastrointestinal Hormones in Dyspeptic Patients

Abstract

Aims: To explore the patterns of gastric electrical activity, gastric emptying and gastrointestinal hormones in dyspeptic patients and relate them to Helicobacter pylori status. Methods: Twenty-two patients with functional dyspepsia and 29 healthy volunteers underwent cutaneous electrogastrography and dynamic ultrasound before and after a test meal. All dyspeptic patients underwent endoscopy and biopsy; all subjects were examined for the presence of antibodies to H. pylori, and the plasma levels of gastrin, neurotensin, cholecystokinin, and pancreatic polypeptide were measured. Results: The area under the curve (AUC) of the normal slow wave percentage was lower in dyspeptic patients than controls (Kruskal-Wallis p = 0.016; Dunn’s test: H. pylori-positive patients: 21,235.5 [19,101.0–22,688.8] vs. H. pylori-negative controls: 22,532.0 [20,133.0–23,755.0], p < 0.05). The AUC of the tachygastria percentage was higher in dyspeptic patients than controls (p = 0.0001; H. pylori-positive patients: 2,173.5 [325.8–3,055.3] vs. H. pylori-negative controls: 682.0 [118.5–1,902.4], p < 0.05; H. pylori-negative patients: 1,843.0 [1,107.0–4,277.0] vs. H. pylori-negative controls: 682.0 [118.5–1,902.4], p < 0.05). The AUC of gastrin was higher in H. pylori-positive than H. pylori-negative subjects (p = 0.0002; H. pylori-positive patients: 16,146.5 [11,368.8–33,141.7] vs. H. pylori-negative controls: 11,250.0 [5,674.0–17,448.0], p < 0.05; H. pylori-positive controls: 20,250.0 [12,070.0–64,430.0] vs. H. pylori-negative controls: 11,250.0 [5,674.0–17,448.0], p < 0.05). In the total group of dyspeptic patients and in the H. pylori-positive patients, a negative correlation was found between the AUC of neurotensin and the total score for postprandial fullness (dyspeptic patients r = –0.51, p = 0.01; H. pylori-positive patients r = –0.66, p = 0.02). Conclusions: In dyspeptic patients, alterations in gastric electrical activity were not related to H. pylori infection. Nevertheless, H. pylori infection induces higher gastrin levels in both patients and asymptomatic subjects.

The role of electrogastrography and gastrointestinal hormones in chemotherapy-related dyspeptic symptoms

“…Concomitant administration of agents known to have significant antiemetic activity, including benzodiazepines and corticosteroids, was not permitted. After informed consent, 25 …”

“…A history of dyspepsia was screened using a previously described, 25 partly modified, symptom questionnaire.…”

“…23,24 All these peptides have also been implicated in the pathophysiology of dyspepsia, and their circulating levels have been associated with impaired GI motility, as expressed by delayed gastric emptying time and gastric electrical activity alterations. 25 Because the role of chemotherapy in the onset of GI motility disorders, in addition to minor GI complaints, has not been clarified yet, we sought to investigate the relationship among the development of dyspepsia, EGG abnormalities (as indices of motility disorders), and circulating levels of GI hormones such as substance P, serotonin, vasopressin, and gastrin in cancer patients well-controlled for emesis.…”

Current status of multichannel electrogastrography and examples of its use

“…There are some reports that %tachygastria in functional dyspepsia patients was significantly higher after a test meal compared with that in healthy persons (49, 50, 52). …”

“…There are many reports that in patients with functional dyspepsia, %normal is low compared with that in healthy subjects (49,50,51,52,53). There are some reports that %tachygastria in functional dyspepsia patients was significantly higher after a test meal compared with that in healthy persons (49, 50, 52).…”