J Rezende-Filho | PubMed Health

PubMed1989

Cisapride stimulates antral motility and decreases biliary reflux in patients with severe dyspepsia.

Duodenogastric reflux has a deleterious effect on the gastric mucosa. It was the aim of this study to assess the acute effects of cisapride on antroduodenal motility and duodenogastric reflux in seven patients with severe dyspepsia and increased biliary reflux, as evidenced by increased bile salt output in their gastric aspirates. Each patient underwent two studies on separate days. On each day, after an overnight fast, each patient swallowed a multilumen tube for manometric recording of gastroduodenal motility. Phenol red was infused into the second portion of the duodenum, gastric juice was aspirated, and motor activity was monitored for 90 min. At the end of this period, the patient received either cisapride or placebo intravenously in a double-blind randomized fashion. Antroduodenal motility and duodenogastric reflux were monitored for the subsequent 90 min. A significantly (P less than 0.01) higher motility index was found in the antrum after cisapride (2678 +/- 712 vs 1110 +/- 412 in the basal period) while placebo had no effect. The duodenal motility index was not affected by cisapride or placebo. Bile salt outputs in gastric aspirates were significantly (P less than 0.05) reduced following cisapride injection (0.42 +/- 0.6 mmol vs 1.6 +/- 1.2 mmol during basal period). Conversely, outputs of phenol red in the gastric aspirates were unaffected by cisapride. In conclusion, cisapride stimulates antral motility and decreases biliary reflux in patients with dyspepsia and increased duodenogastric reflux.

Adult↗

PubMedDate not supplied

[Myoelectric gastric activity using cutaneous electrogastrography--electrogastrogram].

Cutaneous electrogastrography was performed in nine healthy volunteers and in 43 patients presenting with various clinical conditions known to be associated with gastric motor disorders, including: 24 with functional dyspepsia, nine with longstanding diabetes mellitus, five with recent nausea/vomiting, three with pyloric stenosis, one with post-vagotomy gastroparesis, and one with idiopathic gastric distension and atony. The electrogastrography signal was recorded during 1h pre-prandial period and 1h after eating. The electrogastrography dominant frequency and power were determined using running spectral frequency analysis and the time-course of electrogastrography was evaluated in a pseudo three dimensional graphic. The electrogastrography dominant frequency was divided into four bands: 1. Bradygastria (0-2.4 cpm); 2. Normal (2.4-3.9 cpm); 3. Tachygastria (4.0-9.9 cpm); 4. Duod-resp (10.0-15.0 cpm). The percentage of the dominant electrogastrography power into those four frequency bands was determined. Electrogastrography was considered normal if functional dyspepsia was normal in more than 65% of the time. The electrogastrography was normal (dominant frequency into 3 cpm range in > 65%) in: 9/9 healthy volunteers, 3/3 pyloric stenosis, 4/5 nausea/vomiting, 3/9 diabetes mellitus, 13/24 functional dyspepsia. Gastric dysrhythmias were present in > 35% of the electrogastrography recording in: 1/5 nausea/vomiting, 11/24 functional dyspepsia, 6/9 diabetes mellitus, 1/1 post-vagotomy gastroparesis, 1/1 gastric distension and atony. Persistent tachygastria (> 10%) was found in: 1/1 gastric distension and atony (90% electrogastrography), 1/1 post-vagotomy gastroparesis, 1/5 nausea/vomiting, 6/9 diabetes mellitus, 6/24 functional dyspepsia. It was concluded that electrogastrography is a non-invasive, well-tolerated, reliable means of recording gastric myoelectric activity and gastric dysrhythmias. Patients presenting with gastric motor disorders, with chronic dyspeptic symptoms, or acute nausea may present transitory or persistent gastric dysrhythmias.

Adolescent↗