Prevalence of Gastric Myoelectrical Abnormalities in Patients with Nonulcer Dyspepsia and H. pylori Infection

The aims of this study were to investigate the effects of H. pylori eradication on gastric myoelectrical activity and dyspeptic symptoms. Sixty-two subjects with H. pylori infection and no active peptic ulcer participated in this study, which involved three sessions. Anti-H. pylori therapy consisting of clarithromycin and omeprazole was given for two weeks. Gastric myoelectrical activity was measured using surface electrogastrography and dyspeptic symptoms were scored at each session. A [¹⁴C] urea breath test was performed at baseline and one month after treatment. In comparison with baseline, the percentage of normal slow waves was significantly increased and the mean total symptom score was significantly reduced one and three months after therapy (P < 0.05). Approximately 40% of patients with nonulcer dyspepsia symptoms and H. pylori infection have abnormal gastric myoelectrical activity, which may be normalized following the eradication of H. pylori infection. The normalization of gastric myoelectrical activity may be one explanation for the significant symptom improvement in this subset of the dyspepsia population after H. pylori eradication.     

Electrogastrography for psychophysiological research: Practical considerations,analysis pipeline,and normative data in a large sample

Electrogastrography (EGG) is the noninvasive electrophysiological technique used to record gastric electrical activity by means of cutaneous electrodes placed on the abdomen. EGG has been so far mostly used in clinical studies in gastroenterology, but it represents an attractive method to study brain-viscera interactions in psychophysiology. Compared to the literature on electrocardiography for instance, where practical recommendations and normative data are abundant, the literature on EGG in humans remains scarce. The aim of this article is threefold. First, we review the existing literature on the physiological basis of the EGG, pathways of brain-stomach interactions, and experimental findings in the cognitive neuroscience and psychophysiology literature. We then describe practical issues faced when recording the EGG in young healthy participants, from data acquisition to data analysis, and propose a semi-automated analysis pipeline together with associated MATLAB code. The analysis pipeline aims at identifying a regular rhythm that can be safely attributed to the stomach, through multiple steps. Finally, we apply these recording and analysis procedures in a large sample (N = 117) of healthy young adult male and female participants in a moderate (<5 hr) to prolonged (>10 hr) fasting state to establish the normative distribution of several EGG parameters. Our results are overall congruent with the clinical gastroenterology literature, but suggest using an electrode coverage extending to lower abdominal locations than current clinical guidelines. Our results indicate a marginal difference in EGG peak frequency between male and female participants, and that the gastric rhythm becomes more irregular after prolonged fasting.     

小儿慢性胃炎体表胃电图检测

目的　通过体表胃电图描记了解小儿慢性胃炎胃肌电活动规律。方法　对 30例小儿慢性胃炎和 2 0例正常健康儿童进行餐前、餐后体表胃电图描记。结果　观察组较对照组餐后正常慢波百分比显著下降 [(60 3 %± 1 5 8% )vs(71 6 %±1 2 0 % ) ,P <0 0 5) ] ,餐前、餐后正常慢波百分比≥ 65 %所占比例下降无统计学意义 (63 .6 %vs70 .0 % ,P >0 0 5 ;50 .0 %vs70 .0 % ,P >0 0 5) ,餐后节律过缓 (<2 4/min)比例升高 ,但无统计学意义 [(1 8.4 %± 7.2 % )vs(8.5 %± 5 .3 % ) ,P >0 0 5) ] ;实验组胃电图波形奇异、不规则复合波多见。结论　小儿慢性胃炎存在胃电节律改变 ,表现为餐后正常慢波百分比显著下降。胃电图可应用于小儿慢性胃炎的初筛检查     

An improved electrogastrographic system in measuring myoelectrical parameters

This study assessed the reliability of an improved electrogastrographic (EGG) system in recording stomach myoelectrical parameters and tried to establish the normal ranges of myoelectricity using this system. The analytical software of the current system mainly included an autoregressive modelling program to compute myoelectrical frequency and power. Forty healthy subjects were enrolled to receive myoelectrical measurement in two consecutively fasting and one postprandial 30 min sessions. The myoelectrical frequencies in both fasting and postprandial sessions were almost three cycles per min (c.p.m.) and showed little variation. The percentage of dominant frequencies (2.5–3.5 c.p.m.) in three sessions was approximately 80% while the computed myoelectrical powers in the first and second fasting sessions exhibited a significant correlation ( r = 0.84, P < 0.001). Meal ingestion increased the myoelectrical powers by 6.8 dB compared with the second fasting recording ( P < 0.001). The mean variation in myoelectrical amplitude for the ratio of second: first fasting session was 110.3 ± 88.8% (16–478%, median 88%). This new EGG system is, indeed, reliable for measuring myoelectrical frequency and power, whereas the interassay of recorded amplitudes appears markedly variable.     

Role of sham feeding in postprandial changes of gastric myoelectrical activity

The aim of this study was to evaluate the role of sham feeding in postprandial changes of gastric myoelectrical activity. Eighteen asymptomatic healthy volunteers (10 men, 8 women; mean age: 31), with no history of gastrointestinal disease were studied. Gastric myoelectrical activity was recorded for 30 min at baseline, 30 min after sham feeding, and 1 hr after eating, using surface electrogastrography. The electrogastrogram (EGG) was analyzed by spectral analysis. It was found that the changes of postprandial EGG parameters were significantly correlated with those after sham feeding (EGG dominant power:r=0.6,P<0.01; dominant frequency:r=0.8,P<0.001; percentage of regular slow waves:r=0.7,P<0.003). We concluded that intrinsic gastric electrical activity can be altered by sham feeding and the cephalic phase of digestion plays an important role in the postprandial response of gastric myoelectrical activity.     

新生儿胃电图与孕后年龄相关性的分析

目的 胃电图是应用表面电极进行经皮记录下的胃肌电活动情况。由于其具有非侵入性及与胃蠕动的相关性，而激起人们对胃电活动的兴趣，它对新生儿意义非同寻常。而新生儿胃电图资料不多且结果不一。本文欲探讨健康新生儿胃电活动与孕后年龄(胎龄 日龄)的相关性。方法 对23名健康早产儿住院期间每周记录1次胃电活动，19名足月儿分别进行1次胃电活动记录，共计61次。记录时间为餐前、餐后至少60分钟以及用餐时间。应用计算机化的胃电图参数进行分析，相关参数包括主频率(DF)，主频率在正常范围内的百分值(2～4CPM％)，主频率变异系数(DFIC)，餐后与餐前主频率能量比值(PR)。结果 我们未发现EGG参数值与孕后年龄的相关性。餐后2-4CPM％较餐前值显著下降(P=0．032)，餐后DF(P=0．26)，主频率能量(P=0．12)较餐前呈下降趋势，但是餐后DFIC较餐前有增加趋势。结论 在我们的研究中，通过胃电图我们没有发现胃电活动与孕后新生儿年龄的相关性。与其他资料结果相反，我们发现餐后DF，及主频率能量下降。即使胎龄小于35周的早产儿亦能产生胃电活动图形。总之，新生儿胃电图结果还存在许多矛盾之处，有待进一步探讨。     

胃癌患者胃电变化与胃排空的相关性研究

目的 通过胃电图和胃排空检测,了解胃癌患者胃电变化与胃排空之闻有无相关性.方法 对27例胃癌患者(胃癌组)和20例健康者(对照组)同时进行胃电图和胃排空检测.结果 ①胃癌组主功率和胃动过速百分比均高于对照组,正常慢波节律百分比低于对照组.②正常对照者中胃排空正常率75.0%(15/20);胃癌患者中胃排空正常率33.3%(19/27)(P=0.007).胃排空延迟的胃癌患者中,胃电图异常率83.3%(15/18);胃电图异常者中胃动过速73.3%(11/15);胃动过缓26.7%(4/15).胃排空正常的胃癌患者中胃电图异常33.3%(3/9),均为胃动过速.③胃癌组餐前后正常慢波节律百分比与4小时胃排空率之间呈正相关(P＜0.05),胃动过速百分比与4小时胃排空率之间呈负相关(P＜0.05).结论 胃癌患者存在胃电节律紊乱.主要表现为正常慢波节律百分比下降,主功率和胃动过速百分比升高.胃癌组餐前后正常慢波节律百分比与4小时胃排空率之间呈正相关,胃动过速百分比与4小时胃排空率之间呈负相关.     

Electrogastrography as a diagnostic tool for delayed gastric emptying in functional dyspepsia and irritable bowel syndrome

Several pathophysiological mechanisms have been proposed in functional gastrointestinal (GI) disorders, e.g. altered GI motility and sensitivity. The aim of this study was to investigate gastric electrical activity (GEA) in patients with functional dyspepsia (FD) or irritable bowel syndrome (IBS) compared with healthy controls (HC), and to assess if abdominal symptoms and delayed gastric emptying are associated with alterations in GEA, as determined by electrogastrography (EGG). Forty patients with FD, IBS or both were compared with 22 HC. EGG was performed before and after a standard meal. Frequencies and amplitudes pre- and post-prandially were analysed. Furthermore, gastric emptying and symptom scores were assessed. Eight of 40 patients (20%; three FD, three IBS, two FD and IBS) had delayed gastric emptying. Disturbed gastric emptying and lack of a postprandial increase in the EGG amplitude were significantly correlated (r = 0.8; P < 0.005). No differences between controls and patients were observed in the distribution of EGG frequencies. Treatment with the prokinetically active macrolide erythromycin improved gastric emptying, GEA and symptoms (n = 4). The data suggest that EGG could be useful as a diagnostic tool in patients with FD and IBS to identify a subgroup of patients with delayed gastric emptying.     

糖尿病大鼠胃窦肌间神经丛氮能神经的变化及其意义

目的 探讨氮能神经在糖尿病大鼠胃运动障碍中的作用。方法 50只大鼠随机分为正常对照组(n=20)和糖尿病模型组(n=30),用链尿佐菌素建立大鼠糖尿病模型,3个月后记录两组的胃电活动并行胃窦肌间神经丛氮能神经计数。结果 糖尿病模型组胃电节律失常明显增加,异常节律指数(ARI)和慢波频率变异系数(CV)显著增高,胃窦肌间神经丛氮能神经细胞数明显减少,但氮能神经神经节数目无明显改变。结论 糖尿病大鼠胃窦肌间神经丛氮能神经改变可能是导致其胃电节律失常和胃运动障碍的原因之一。     

Study on the effect of Jia‐Wei‐Xiao‐Yao‐San decoction on patients with functional dyspepsia

The effect of Jia‐Wei‐Xiao‐Yao‐San (JWXYS) decoction on patients with functional dyspepsia was studied by means of electrogastrography (EGG) and symptoms of dyspepsia were assessed. Twenty patients with functional dyspepsia were selected; before and after internal treatment with JWXYS, the integrated symptoms of the patients were down‐regulated from 18.55 ± 3.24 (before treatment) to 11.65 ± 2.37 (after treatment) (p < 0.01); electrogastrography showed that all the EGG parameters of the patients were outside the normal range. After treatment with JWXYS, all these indices improved before and after dinner. The results showed that the JWXYS decoction could not only improve the symptoms, but also adjust the abnormal gastric motility and gastric myoelectrical activity of patients with functional dyspepsia. Copyright © 2009 John Wiley & Sons, Ltd.