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PubMedDate not supplied

Abnormal gastric and small intestinal motor function in diabetes mellitus.

It is now well recognized that the prevalence of delayed gastric emptying in both insulin-dependent as well as noninsulin-dependent diabetes mellitus is high. Recently performed studies have shown that motor disorders of several parts of the upper gastrointestinal tract contribute to this delay in gastric emptying. Traditionally, disordered motility in diabetes mellitus has been attributed to irreversible autonomic nerve damage. However, recent observations indicate that hyperglycemia causes a reversible impairment of motility in various regions of the gastrointestinal tract. Upper gastrointestinal symptoms are highly prevalent in diabetes mellitus. These dyspeptic symptoms are not only induced by delayed gastric emptying, but altered visceroperception also plays a role in the genesis of dyspeptic symptoms. There is increasing evidence that impaired gastric emptying influences glycemia control, but the clinical consequences of these observations need further investigation. At present dyspeptic symptoms form the rationale for the treatment of delayed gastric emptying with prokinetic drugs.

Diabetes Complications↗
PubMed1991

Effects of age and obesity on fasting gastric electrical activity in man: a cutaneous electrogastrographic study.

We investigated the effects of age and obesity on the fasting cutaneous electrogastrogram (EGGc) by studying both young and aged, healthy men. All subjects underwent an electrogastrographic recording lasting 1 h, and frequency and power data were obtained by means of spectral analysis. In order to make a precise comparison of the data, each subject's body mass index (BMI) was calculated and each age group was subdivided into nonobese subjects, those with a BMI of less than 24.9 kg/m2, and obese subjects, those with a BMI of more than 25 kg/m2. Comparison of the mean frequency values of the gastric spectral peak did not reveal statistically significant differences among the groups (young vs. old, nonobese vs. obese). Comparison of the mean power values of the gastric spectral peak, on the other hand, showed that there was a statistically significant reduction in spectral power in the aged subjects compared with the young (p = 0.017 in the aged vs. young nonobese subjects and p = 0.009 in the aged vs. young obese subjects), and in the obese subjects compared with the nonobese (p = 0.00021 in the young and p = 0.00029 in the aged). Frequency, therefore, is the parameter of gastric electrical activity which may best be studied by means of EGGc as it is only very slightly affected by physiological parameters, such as age and the adiposity of subjects. EGGc, therefore, could be useful in the study of those gastric diseases associated with disorders in gastric electrical rhythm and rate.

Adult↗
PubMed1994

Electrical activity recorded from abdominal surface before and after right hemicolectomy in man.

To explain the origin of the electrical signals obtained from the abdominal cutaneous surface (electrosplanchnogram, ESG), the ESG was recorded in 6 patients with carcinoma of the right colon without obstruction before and after right hemicolectomy. The analysis of colonic electrical activity was performed by means of spectral analysis that utilized fast Fourier transform method. Since the colonic electrical signal is highly complex and it may contain several frequencies concurrently the spectral frequency components were subdivided in ranges and the dominant frequency and power were calculated for each range before and after surgery. The pattern obtained from power profile, expressed as differences in power percentages before and after surgery, demonstrated that there were significant differences in power data from right hemicolectomized patients compared to cholecystectomized ones (p = 0.00001 and p = 0.001 in 2.5-3.5 and 3.6-7.5 cpm range, respectively). In particular, hemicolectomized patients showed a slight increase of power percentage in the 2.6-3.5 cpm range and a clear reduction in the 3.6-7.5 cpm range. These data suggest that there are several components of colonic origin in the cutaneous ESG signal which, in the right colon, are identifiable in the 3.6-7.5 cpm range.

Abdomen↗
PubMed2004

Gastric emptying is slow in chronic fatigue syndrome.

BACKGROUND: Gastrointestinal symptoms are common in patients with Chronic Fatigue Syndrome (CFS). The objective of this study was to determine the frequency of these symptoms and explore their relationship with objective (radionuclide) studies of upper GI function. METHODS: Thirty-two (32) patients with CFS and 45 control subjects completed a questionnaire on upper GI symptoms, and the 32 patients underwent oesophageal clearance, and simultaneous liquid and solid gastric emptying studies using radionuclide techniques compared with historical controls. RESULTS: The questionnaires showed a significant difference in gastric (p > 0.01) symptoms and swallowing difficulty. Nocturnal diarrhoea was a significant symptom not previously reported.5/32 CFS subjects showed slightly delayed oesophageal clearance, but overall there was no significant difference from the control subjects, nor correlation of oesophageal clearance with symptoms. 23/32 patients showed a delay in liquid gastric emptying, and 12/32 a delay in solid gastric emptying with the delay significantly correlated with the mean symptom score (for each p < 0.001). CONCLUSIONS: GI symptoms in patients with chronic fatigue syndrome are associated with objective changes of upper GI motility.

Adult↗
PubMed1996

Organization of the vagal preganglionic neurons innervating the stomach in the Japanese quail (Conturinx japonica) double labeling fluorescent method.

Cytoarchitectural study indicated that the dorsal motor nucleus of the vagal nerve (nX) was formed by two subnuclei in a coronal section. One of them had large and round neurons, and occupied the dorsal part of the nX (Xd). The second one had small and oval neurons, and occupied the ventral part of the nX (Xv). The double labeling fluorescent method was performed to determine the organization of preganglionic neurons in the nX innervating different muscles of the quail stomach. Injections of nuclear yellow (NY) into the proventriculus, and of fast blue (FB) into the gizzard showed that there were no double-labeled neurons in the nX. NY- and FB-labeled neurons were found throughout the nX. After separate injections of NY and FB into both the cranioventral and caudodorsal thick muscles, and the craniodorsal and caudodorsal thin muscles, many NY- and FB-labeled neurons were distributed and intermingled in the middle two thirds of the nX. Considerable numbers of double-labeled neurons were also found at the middle level of the nX. There was no side-predominancy of the population of the preganglionic neurons innervating the quail stomach. These results show that, many neurons of both sides of the nX are separately innervating both the proventriculus and gizzard, and considerable numbers of single neurons of the nX also innervate a pair of thin or thick muscles with collateral axons.

Amidines↗
PubMed2003

Transcutaneous electrogastrography in the perioperative period in patients undergoing laparoscopic cholecystectomy and laparoscopic non-adjustable gastric banding.

BACKGROUND: Transcutaneous electrogastrography (EGG) is a non-invasive method of examination that allows monitoring of gastric myoelectric activity. The goal of this prospective study was to describe changes in gastric motility in the early postoperative period in extremely obese patients, who underwent planned surgery--Laparoscopic Non-Adjustable Gastric Banding (LNGB) and to establish the specificity of observed differences for this intervention. PATIENTS AND METHODS: Myoelectric gastric activity was evaluated in the perioperative period in 20 extremely obese patients undergoing LNGB. The results of monitoring up to +24 h after the intervention were compared to a group of 15 healthy volunteers, and to a group of 20 patients undergoing laparoscopic cholecystectomy (LC). The recording was performed in both the patient and control groups 24 h before the operation and +5 h, +24 h and +48 h after the surgery, both in the fasting state and after stimulation with a liquid bolus. The data were recorded using the Microdigitrapper device and analyzed using the spectral analysis and Fourier transformation. RESULTS: The finding characteristic in the early postoperative period was a decrease in frequency of both spontaneous and stimulated gastric contractions (bradygastria) at +5 h after the intervention, that was followed by rapid return to baseline activity. In patients after LNGB, the normalization of motility was seen within 24 h, and in patients after LC within 48 h after the intervention. Tachygastria was not found in any patient who did not have complications, but on the contrary it was found in both patients with significant dyspepsia after LC. CONCLUSIONS: In the early postoperative period after LNGB, significant changes in myoelectric gastric activity were seen and were characterized by transient bradygastria. Comparison with the reference group of patients after LC shows that the intensity and duration of basal and stimulated bradygastria has a non-specific relationship with the extent of tissue trauma caused by the intraabdominal surgery. It is not specific for the gastric banding itself. The method of measuring the basal stimulated EGG potentials can be used in routine surgical practice as an auxiliary method for evaluation of the functional status of the gastrointestinal tract after intraabdominal surgery.

Adult↗
PubMed2003

Gastric myoelectrical activity in morbidly obese patients before and 3 months after gastric restrictive surgery.

BACKGROUND: Morbid obesity is often associated with gastrointestinal motor disorders. The aim of this study was to investigate gastric motility in morbid obesity, using electrogastrography (EGG) before and 3 months after gastric restrictive surgery. METHODS: 40 morbidly obese subjects (age 40.6+/-10.3 years, BMI 46.4+/-5.7 kg/m2) were studied. VBG and Lap-Band operations were performed in 19 and 21 patients respectively. The following EGG-parameters were determined, both during fasting (f) and postprandially (pp): dominant frequency (DF(f/pp)), dominant power (DP(f/pp)), dominant frequency and power instability coefficient (DFIC and DPIC respectively) and power ratio. RESULTS: In the Lap-Band group, DF(pp), DP(pp) and DFIC(pp) were significantly higher compared with the preprandial state, both preoperatively and 3 months postoperatively. After VBG, DF(f) and DFIC(pp) were significantly lower and DPIC(f) significantly higher compared with the preoperative state. Furthermore, DF(pp) and DP(pp) were significantly higher than the preprandial values. However, in both types of operations, power ratio did not differ significantly between the preoperative and postoperative situation. Furthermore, no clear difference in EGG-parameters between both operations could be observed. CONCLUSION: After gastric restrictive surgery, no major changes in gastric myoelectrical activity occurred, suggesting that if clinical motility problems occur after bariatric surgery, they are not due to gastric myoelectrical dysfunction.

Adult↗
PubMed2005

Implantable gastric stimulation inhibits gastric motility via sympathetic pathway in dogs.

BACKGROUND: The aim of this study was to investigate the effect of implantable gastric stimulation (IGS) on gastric antral contractions and the involvement of the sympathetic pathway. METHODS: The study was performed in 5 postprandial sessions in 8 dogs chronically implanted with stimulation electrodes and a gastric cannula: a) IGS via lesser curvature; b) IGS via antrum; c) and d) same as a) and b) but IGS initiated 1 hr before the meal; e) same as a) but with guanethidine. RESULTS: It was found that: 1) IGS significantly inhibited postprandial antral contractions assessed by manometry, and no significant difference was noted in the effect between the two stimulation sites; 2) IGS initiated 1 hr before the meal was more potent than that initiated 30 minutes after the meal; 3) the inhibitory effect of IGS on postprandial antral motility was completely blocked by guanethidine. CONCLUSION: Acute IGS inhibits postprandial antral contractions, and this inhibitory effect is mediated via the sympathetic pathway.

Analysis of Variance↗
PubMed2005

Visceral sensitivity to gastric stimulation and its correlation with alterations in gastric emptying and accommodation in humans.

BACKGROUND: The aim of this study was to investigate the visceral sensation to gastric stimulation and its correlation with the stimulation-induced alterations in gastric accommodation and gastric emptying. METHODS: The study was performed in 12 healthy human controls. Gastric stimulation was performed using bipolar electrodes attached to the mucosa of the distal stomach under endoscopy. Experiments were conducted on 3 consecutive days to investigate the effects of gastric stimulation with various parameters on visceral sensation, maximum intake of water and gastric emptying of solids. RESULTS: 1) The stimulation energy was 265.6 +/- 134.9 smA 2 for the first sensation and 2,020.0 +/- 865.1 smA2 for the maximum tolerance, and there was a large variation among the subjects; 2) Gastric stimulation with stimulation energy less than 50% of that required to induce the first sensation significantly reduced the maximum intake of water and delayed gastric emptying of solids without inducing symptoms; 3) The stimulation energy of the first sensation was significantly correlated with the stimulation-induced reduction in water intake (r=-0.80, P=0.02) and the stimulation-induced prolongation of gastric emptying (r=-0.78, P=0.003). That is, the inhibitory effects of gastric stimulation were more obvious in those subjects who were viscerally more sensitive to gastric stimulation. CONCLUSIONS: Gastric stimulation via the distal stomach reduces gastric accommodation and delays gastric emptying. These inhibitory effects are correlated with the visceral sensitivity of the individual to gastric stimulation. It is worthy to further investigate whether the outcome of the implantable gastric stimulation (IGS) therapy for obesity may be predicted from the visceral sensitivity of the patient to temporary gastric stimulation using endoscopically placed mucosal electrodes.

Adaptation, Physiological↗
PubMed2005

Effects and mechanisms of implantable gastric stimulation on gastric distention in conscious dogs.

BACKGROUND: While implantable gastric stimulation (IGS) on the lesser curvature has been reported to induce weight loss in obese patients, its mechanisms involving gastric mechanical activity remain largely unknown. The aim of this study was to investigate the effect and mechanism of IGS on gastric tone in canines. METHODS: 8 healthy dogs were implanted with a gastric cannula on anterior stomach and a pair of electrodes at lesser curvature. Gastric tone was assessed with an electronic barostat in 2 randomized sessions, a control and a session with L-NNA (nitric oxide synthase inhibitor). The control session included 30 min baseline, followed by 30 min with IGS; the L-NNA session included 30 min baseline, 30 min immediately after a bolus of L-NNA, and 30 min with IGS. RESULTS: 1) In the control session, IGS significantly increased the proximal gastric volume from baseline 91.3+/-7.1 ml to 186.3+/-27.1 ml (P<0.05); 2) L-NNA markedly reduced the proximal gastric volume from 110.3+/-11.9 ml to 56.9+/-10.8 ml (P<0.01); and subsequent IGS did not significantly increase the proximal gastric volume (P>0.05). CONCLUSION: IGS significantly inhibits proximal gastric tone or induces gastric distention, and this inhibitory effect is mediated via the nitrergic pathway.

Analysis of Variance↗
PubMed2003

Gastric myoelectrical activity in patients with recurrent gastric or duodenal ulcers.

The aim of this study was to characterize gastric myoelectrical activity in patients with recurrent gastric ulcer (GU) or duodenal ulcer (DU), and to compare gastric motility between these two groups of patients. Studies were performed in 59 patients with recurrent active peptic-ulcer disease as diagnosed by gastrointestinal endoscopy: 31 patients had a GU and 28 patients had a DU. Gastric myoelectrical activity was evaluated by cutaneous electro-gastrography (EGG). The following EGG parameters were assessed: the percentage of normogastria (regular 2.4-3.6 cpm slow waves); the EGG power ratio; and the occurrence of a postprandial dip (PD), which is the transient decrease in EGG frequency after a meal. In the GU group, no significant change occurred in the percentage of normogastria or in the EGG power ratio observed after treatment with a proton-pump inhibitor. During the healed stage, the occurrence of PD remained unchanged. In contrast, in the DU group, the percentage of normogastria and the EGG power ratio were significantly increased after treatment. Moreover, during the healed stage, the occurrence of PD significantly increased compared with that during the active stage. These findings suggest that abnormal gastric myoelectrical activity plays an important role in the pathophysiology of recurrent GU rather than DU.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2005

Does body posture affect the parameters of a cutaneous electrogastrogram?

In a study aimed to test the effect of body position on the parameters derived from surface electrogastrograms, 17 healthy volunteers (2M, 15F; median age 22.5 years) attended in random order two examination sessions held on separate days. A 30-min recording of the interdigestive gastric myoelectrical activity (GMA) was followed by a 90-min postprandial recording after intake of a 394 kcal mixed solid-liquid test meal. For the first examination the subject was examined in a recumbent position, whereas for the second examination a sitting position was maintained. The dominant frequency and relative time occupied by normogastria was negligibly affected by the posture of the subject during GMA recording. However, a decrease in the dominant power (DP) of the gastric slow waves was observed during both the interdigestive and the postprandial recording period in a sitting position compared to a recumbent position. Consequently, the fed to fasted state DP ratio remained unaffected by body posture during GMA recording. The results indicate that by carefully observing procedural guidelines, good quality electrogastrograms can be obtained with a sitting subject, enabling the provision of comparable parameters to those achieved from standard examination in a recumbent position.

Adult↗
PubMed2006

Clinical utility of electrogastrography and the water load test in patients with upper gastrointestinal symptoms.

We assessed gastric myoelectric functioning in patients with various gastrointestinal symptoms and to determine the utility of electrogastrography in differentiating specific disease entities. Electrogastrography with a water load was performed in 101 patients with reflux disease, 55 patients with active gastric ulcer, 59 patients with functional dyspepsia, and 30 controls. Upper gastrointestinal symptoms were assessed in each patient. Electrogastrography was abnormal in 41 (40.6%) patients with reflux disease, 31 (56.4%) patients with active gastric ulcer, and 26 (44.1%) patients with functional dyspepsia (P=NS). Water load tolerance was greater in controls than any patient group (all P<0.05). Symptoms predicted abnormal electrogastrography in reflux patents with satiety (OR=2.9; P<0.05) and in dyspeptic patients with nausea (OR=3.1; P<0.05). Although electrogastrography is helpful in differentiating subgroups of patients with nausea or satiety, it cannot directly differentiate disease states such as reflux disease, gastric ulcer, and functional dyspepsia.

Diagnosis, Differential↗
PubMed2003

Gastric myoelectrical activity in neonates of different gestational ages by means of electrogastrography.

PURPOSE: to describe the patterns of the gastric myoelectrical activity, pre-and postprandially, in clinically stable neonates of different gestational ages, during their first two weeks of life by means of Electrogastrography. PATIENTS AND METHODS: Electrogastrography was recorded in forty-five clinically stable neonates of different gestational ages (group I: 15 neonates of > 37 weeks, group II: 15 premature neonates of 32-37 weeks; Group III: 15 premature neonates of 28-31 weeks) receiving intermittent enteral feedings during their first two weeks of life. Electrogastrography recordings were performed for 1 hour pre-and postprandially. The Electrogastrography signal was recorded using the portable MicroDigitrapper Electrogastrography recording device and after motion artifacts were deleted, the remaining Electrogastrography data were submitted to quantitative analysis based on the "Running Spectrum Analysis". RESULTS: The percentages of normogastria, pre-and postprandially were greater than the percentages of gastric dysrythmias in all three studied groups. Furthermore, all neonates had the mean values of the Electrogastrography dominant frequency predominantly within the normogastria range, in both periods analyzed. There were no significant differences in the relative change of the Electrogastrography dominant power among the groups. CONCLUSION: This study demonstrates that the Electrogastrography patterns are similar between premature and full term neonates during the pre-and postprandial periods. The results of this study also indicate that the gastric myoelectrical activity in premature and full term neonates is immature, as compared to that described for older neonates, children and adults.

Electromyography↗