Postprandial symptoms in dysmotility-like functional dyspepsia are not related to disturbances of gastric myoelectrical activity

Abstract

Gastric dysrhythmias, such as tachy-or bradygastria, have been reported in patients with functional dyspepsia (FD), but their role in symptom production is uncertain. It is also not known whether gastric dysrhythmias in these patients can be elicited by physiological gastric distension with a meal. We investigated the relationships between symptoms after ingestion of different volumes of water following a test meal and gastric dysrhythmias in FD patients. Fourteen patients with dysmotility-like FD and 13 healthy volunteers underwent paired electrogastrography (EGG) studies. Fasted subjects ingested 150 ml of yoghurt with either 150 ml (low volume) or 300 ml (high volume) water in random order. Fasting and fed EGGs with monitoring of symptoms were performed in both studies. Ten FD patients (71.4%) reported upper abdominal discomfort and bloating after the low volume meal, but only one (7.1%) presented an abnormal EGG (dominant frequency in the 2-4-cpm range: 58%). Following the high volume meal, 7 patients (50%) had symptoms, but none had EGG abnormalities. No significant differences were found between FD patients and controls for any of the EGG variables, in any test. In FD patients with postprandial symptoms, the percentage of the EGG dominant frequency in the normal range (median, 84.6%; range, 76.0-100.0%) was similar (P > 0.20) to that in those without symptoms (88.5%; 75.0-100.0%). We conclude that disturbances of gastric myoelectrical activity are unlikely to play a role in the origin of postprandial upper abdominal discomfort and bloating in dysmotilitylike FD.

Magnetogastrographic detection of gastric electrical response activity in humans

“…The presence of abnormal ECA propagation patterns was found to be associated with gastric outlet obstruction (Brzana et al 1998, Smith et al 2003, gastroparesis (Smith et al 2003), gastric myoelectrical dysrhythmia (Qian et al 2003), atrophy and hypertrophy (Bortoff and Sillin 1986), diabetic gastropathy (Koch 2001) and Chagas disease (Madrid et al 2004), although no statistically significant differences were found between normal and abnormal EGG-recorded ECA patterns for human cases of achalasia (Verhagen et al 1998) and dysmotility-like functional dyspepsia (Oba-Kuniyoshi et al 2004, van der Voort et al 2003.…”

Gastric myoelectrical activity abnormalities of electrogastrography in patients with functional dyspepsia

“…However, Jebbink et al (12) found no significant difference between the patients in FD and the control groups with respect to the incidence of dysrhythmia. Similarly, Oba-Kuniyoshi et al (13) in their study on the dysmotility-like FD patients, reported no significant difference between the FD patients and the control subjects in terms of dysrhythmia. Inconsistency among the results of the studies may be caused by the fact that they have been conducted on patients with different diagnoses and that the diagnostic criteria for FD may vary.…”

“…Although much improvement has been made in the EGG field within the last twenty years, difficulties experienced in the recording of myoelectrical activity and analysis of the obtained signals still persist (9). Some studies have revealed statistically significant differences between the patients with FD and healthy control groups with respect to EGG parameters (6,11), while some others have not (12,13). On the other hand, Pfaffenbach et al (14) have detected a significant difference only in preprandial dysrhythmia whereas no postprandial difference has been detected.…”

Pathogenesis and therapy for idiopathic dyspepsia

“…In a Brazilian study using electrogastrography (EGG) in patients with motilitylike FD, disturbances of myoelectrical activity were not related to the occurrence of postprandial discomfort and bloating [45].…”