Electrical activity from colon overlaps with normal gastric electrical activity in cutaneous recordings

The stability of EGG recordings is affected by a variety of artifacts. The aim of this study was to investigate possible overlapping of dominant frequencies in recorded cutaneous electrical activity arising simultaneously from the stomach and/or colon. Ten normal volunteers, eight posttotal colectomy patients, and four patients posttotal gastrectomy were studied. Fasting cutaneous recordings were obtained using four pediatric ECG electrodes attached to the abdominal surface. Electrical activity was recorded and digitally analyzed using custom-designed software. Spectral analysis after gastrectomy and colectomy showed persistence of power peaks in the gastric electrical activity range of frequency (2.5–3.75 cpm). In conclusion, noninvasively obtained colonic frequencies overlap EGG. This hypothesis is supported by the persistence of power peaks in the EGG range of frequency after gastrectomy and colectomy. Therefore, we conclude that contribution of electrical activity arising from the colon could substantially affect EGG recordings.     

Esophageal cancer after distal gastrectomy

The effect of gastrectomy on the subsequent development of esophageal cancer was investigated. Duodenogastroesophageal reflux is thought to be common in patients after distal gastrectomy, but whether this contributes to the development of esophageal cancer in such patients is controversial. We retrospectively evaluated 153 patients who underwent subtotal esophagectomy for thoracic esophageal cancer between January 2002 and July 2005. They were divided into two groups, according to whether or not they had previously undergone a gastrectomy: group 1, comprising 14 patients who had undergone gastrectomy and group 2, comprising 139 patients who had not. Clinical profiles of the patients were obtained from the medical records and the whole resected esophagus was histopathologically examined. The interval between gastrectomy and esophagectomy in group 1 was significantly shorter in the patients who had undergone gastrectomy for gastric cancer (10.5 +/- 4.2 years) than in those who had undergone gastrectomy for a peptic ulcer (28.9 +/- 3.0 years). The interval was also somehow shorter in the patients for whom anastomosis had been performed by Billroth I (21.3 +/- 5.6 years) compared with Billroth II (29.7 +/- 3.2 years), although the difference did not reach its statistical significance (P = 0.11). Moreover, the proportion of lower third tumors in patients after gastrectomy was significantly higher compared with that of the patients with intact stomach. These findings suggest that a history of gastrectomy is associated with more lower-third squamous cell esophageal carcinoma.     

Gastric myoelectrical activity post-chemoradiotherapy and esophagectomy: a prospective study using subscapular surface recording

The aims of this study were to prospectively evaluate gastric function in esophageal cancer patients after chemoradiotherapy and following surgery, using cutaneous electrogastrography (EGG). Twenty-three patients with esophageal adenocarcinoma were recruited to the study. A subset of patients (n = 11) underwent neoadjuvant chemoradiotherapy and were also studied at 14 days after treatment. All patients underwent EGG studies prior to and following surgery, at 3 months postoperatively. Ten of these patients were also studied at medians of 6 months and 12 months after surgery. Twenty normal volunteers were used as controls. Post-operative EGG studies were monitored with a modified technique; the electrodes being placed in the subscapular region in the area of the transposed stomach. Following neoadjuvant treatment there was a significant increase in abnormal gastric myoelectrical activity involving changes in tachygastrias and decreased motility as measured by power ratio. Post-operatively there was a significant increase in bradygastria which persisted at 6 months but not at 12 months. There was a corresponding decrease in normogastria which persisted at 6 months and to a lesser extent at 12 months. Dominant frequency remained significantly depressed at 3, 6 and 12 months. Gastric myoelectrical activity is normal in untreated esophageal cancer. Neoadjuvant chemoradiotherapy causes a disruption to normal myoelectrical activity involving reduced motility and tachygastrias. Surgery causes a depression in dominant frequency with a reduced incidence of normogastria at 3 months and 6 months but with a tendency towards normality at 12 months.     

Electrogastrographic Study of the Effect of Transcatheter Arterial Chemoembolization on Gastric Myoelectric Activity

Background: Transcatheter arterial chemoembolization (TACE) of the hepatic artery is frequently used in the treatment of inoperable hepatocellular carcinoma (HCC). TACE causes not only effective tumor tissue necrosis in patients with hepatoma but also adverse effects on extrahepatic abdominal organs. There are no published reports on the effect of TACE on the gastric myoelectric activity. In this study, using cutaneous electrogastrography (EGG), we evaluated the effect of TACE on gastric myoelectric activity in patients with HCC. Methods: A total of 27 patients (24 men and 3 women, aged 22 to 78 years) with hepatoma, admitted for TACE, were included in this study. Furthermore, 28 patients (24 men and 4 women, aged 26 to 75 years), admitted for diagnostic angiography of the liver, served as the control group. Cutaneous EGG was performed before and after TACE or angiography. Results: In the TACE group there were significant changes in dominant frequency (DF) and percentages of DF in the defined normal range, bradygastric range, and tachygastric range on post-meal EGG. On fasting EGG, only the dominant frequency and percentages of DF in the bradygastric range changed significantly. However, there was no correlation between the occurrence of nausea/vomiting and the degree of change in the EGG variables, during both fasting and postprandial states. In the control group there were no significant differences in EGG variables before and after angiography. Conclusions: TACE can affect gastric myoelectric activity in HCC patients. Nevertheless, the relationship between changes in myoelectric activity and the occurrence of gastrointestinal symptoms needs further investigation.     

Electrogastrography in patients with Roux-en-Y reconstruction after previous Billroth gastrectomy

BACKGROUND/AIMS: The aim of this prospective study was to characterize gastric myoelectrical activity in patients with Roux-en-Y reconstruction after previous Billroth gastrectomy. METHODOLOGY: Thirteen patients entered the study (6 men and 7 women, aged 35-57). The mean time from Roux-en-Y reconstruction to electrogastrography (EGG) recording was 5 years. Surface cutaneous EGG was recorded using a Digitrapper EGG in the morning both fasting and after a standard solid test meal. All patients assessed their dyspeptic symptoms at the time of EGG in a semi-quantitative subjective scale. RESULTS: EGG was abnormal in all studied patients (but one postprandial recording). Dyspepsia was not meal-related and was not more severe in Helicobacter pylori positive patients. There was a significant negative correlation between time from Roux-en-Y reconstruction to EGG recording and bradygastria percent activity, both fasted and postprandial (r = -0.576; p = 0.0022). There was an inverse trend between severity of dyspepsia and normal slow-wave rhythm percent activity. Older patients tended to have more severe dyspepsia. CONCLUSIONS: The results of this study suggest that abnormal EGG recording is associated with dyspepsia in patients after Roux-en-Y reconstruction.     

Delayed gastric emptying in patients with diffuse versus limited systemic sclerosis, unrelated to gastrointestinal symptoms and myoelectric gastric activity

OBJECTIVE: To study the gastric function in patients with diffuse and limited systemic sclerosis (SSc) in relation to the degree of upper gastrointestinal symptoms. METHODS: Scintigraphic gastric emptying and recording of the myoelectric signals of the stomach were examined in 15 patients with diffuse SSc (dSSc), 13 patients with limited SSc (lSSc) and 15 healthy controls. The frequency of upper gastrointestinal symptoms was determined using a questionnaire. RESULTS: Patients with dSSc had slower gastric emptying (scintigraphic gastric half-emptying time median (Md) 103 min, range 75-447 min) than control subjects (Md 70 min, range 38-94) and patients with lSSc (Md 76 min, range 43-460). Electrogastrographic recordings did not differ between dSSc, lSSc or controls. Symptoms tended to be more abundant in dSSc patients than in lSSc patients, however, patients with a high frequency of symptoms did not differ from patients with low frequency of symptoms in gastric function, as measured with scintigraphic gastric emptying or electrogastrography (EGG). Neither EGG nor a thorough review of upper gastrointestinal symptoms could predict delayed gastric emptying. CONCLUSION: The higher prevalence of delayed gastric emptying in patients with dSSc in this study indicates a more severe involvement of the gastrointestinal tract in dSSc than in lSSc, and stresses the importance of differentiating between the subtypes of SSc patients. Since EGG dysrythmia did not correlate with gastric emptying we concluded that factors other than defective myoelectric signals might contribute to a disturbed gastric function.     

Pre- and postoperative electrogastrography in patients with gastric cancer

BACKGROUND/AIMS: To investigate the changes of electrogastrography (EGG) after stomach resection, fasting and postprandial EGG were recorded in 10 volunteers and 23 gastric cancer patients who had undergone total or subtotal gastrectomy. METHODOLOGY: EGG signals in patients were recorded before and after surgery and were analyzed by power spectrum. RESULTS: The power spectrum components at three cycles/minute (cpm) as normal subject, had completely disappeared in all patients after total gastrectomy, and irregular powers, especially under 9 cpm, had increased. These results suggest that the activity of the 3-cpm component is specific for the stomach. In subtotal gastrectomy patients, 3-cpm power peaks were clearly observed in seven of twelve patients, but it was not recorded in the remaining five patients, who showed irregular powers similar to that in patients after total gastrectomy. Therefore, it was speculated that the area containing the "pacemaker" of gastric electric potentials was removed during gastrectomy in these five patients. The postprandial dip, which is considered to reflect autonomic nervous function, was not observed in six of seven subtotal gastrectomy patients who demonstrated the 3-cpm component in their EGG, and it was speculated that the gastric branch of the vagus nerve in these six patients might have been partially removed by surgery. CONCLUSIONS: These findings suggest that EGG is available as a non-invasive method to evaluate the motility and autonomic function of the remnant stomach after gastrectomy.     

Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia report of three cases

Summary Three children (ages 5, 7.6, and 8 years), with recurrent unexplained upper abdominal symptoms such as vomiting, epigastric pain, anorexia, early satiety and without structural or mucosal abnormalities of gastrointestinal tract, underwent electrogastrography (EGG)—recording of gastric electrical activity using cutaneous electrodes positioned on the epigastric region and connected to a recording polygraph. Frequency of EGG signals was analyzed by fast Fourier transform. Significant changes of fasting and fed gastric myoelectrical activity (tachygastria, bradygastria, flatline pattern) were recorded in the three patients; furthermore, gastric emptying (GE) of a solid-liquid mixed meal, measured by ultrasonography, was significantly prolonged in them. A follow-up study was carried out after an eight-week course with oral cisapride: in all patients symptoms improved, GE time normalized, and EGG analysis showed normal electrical rhythm. It is suggested that gastric dysrhythmias can play a pathogenetic role in patients with functional gastrointestinal symptoms and that symptomatic improvement is accompanied by normalization of gastric electrical rhythm.     

Multichannel electrogastrography (EGG) in symptomatic patients: a single center study

OBJECTIVES: To determine the value of multichannel versus conventional single-channel electrogastrography (EGG) and of an additional postprandial hour recording in symptomatic patients. METHODS: Eighteen normal subjects and 47 patients with upper GI symptoms underwent multichannel EGG with four cutaneous recording electrodes placed on the antral axis. Fasting EGG was recorded for 1 h, followed by meal ingestion, followed by two 1-h postprandial EGG recordings. Variables assessed: (1) dominant frequency (DF) and its power; (2) percent time in normal (2-4) cpm frequency; (3) average percent of slow wave coupling (% SWC). RESULTS: Normal values for single-channel EGG were: (1) DF from 2.5-3.3, 2.7-3.5, and 2.6-3.5 cpm in the fasting, first, and second postprandial hours; (2) percentage of time in 2-4 cpm: >50%, >65%, and >65% in the fasting, first, and second postprandial hours. Normal values for percent SWC using multichannel EGG were >50%, >55%, >55% in the fasting, first, and second postprandial hours. In the symptomatic patients, an abnormal 2-h single-channel EGG was obtained in 16 of 47 (34%) patients. Adding an additional 1 h of postprandial recording identified another 4 abnormal patients (20/47 = 43%). With multichannel EGG, abnormal results were obtained in 24 of 47 patients (51%) with the 2-h study. An additional 1 h of postprandial recording identified another 4 patients as abnormal (28/47 = 60%). CONCLUSIONS: Multichannel EGG recording improved the detection of abnormal gastric myoelectric activity in symptomatic patients. This study also demonstrates prolonging the postprandial recording to 2 h increases the diagnostic yield for both single-channel and multichannel EGG.     

Electrogastrography: possibilities and limits

A cutaneous electrogastrogram (EGG) is a recording of the electrical activity of the stomach by means of electrodes placed on the abdominal skin surface. Recently, there has been an increased interest in the cutaneous EGG due to the development of new recording techniques and improved methods of signal analysis, and as a result of these developments recent studies have been able to demonstrate that alterations in gastric electrical activity may be accompanied by unexplained nausea and vomiting. In spite of the diagnostic potential of the cutaneous EGG, there are numerous problems which must be resolved before widespread clinical use is possible. The authors review the current status of the cutaneous EGG and describe their own experience of its use in the study of certain organic gastric diseases.     

Long-term and short-term evaluation of esophageal reconstruction using the colon or the jejunum in esophageal cancer patients after gastrectomy

SUMMARY.  For esophageal cancer patients, the gastric tube is the first choice as an esophageal substitute, with the colon or the jejunum being used when the stomach cannot be used. We retrospectively compared these two methods from the viewpoint of peri-operative complications and long-term bodyweight alteration. From 1998 to 2005 53 patients who had undergone subtotal esophagectomy due to thoracic esophageal cancers were given reconstruction with the colon (28 cases) or the jejunum (25 cases). Both intestines were reconstructed via the subcutaneous route and were anastomosed to the internal mammalian artery and vein for a supercharged blood supply. There was no difference in operating time and blood loss. Compared with the colon reconstruction group, the hospital stay of the jejunum reconstruction group was significantly shorter (65 days vs 45 days, P  = 0.0120) and the incidence of anastomotic leakage tended to be less (13 cases, 46% vs 6 cases, 24%, P  = 0.1507), while other operative morbidity did not differ between the two groups. Bodyweight loss, which is a serious postoperative sequela after esophagectomy, was less in the jejunum group than in the colon group, showing a significant difference at 12 months after surgery. Our retrospective study revealed the jejunum to be superior to the colon for the reconstruction after esophagectomy along with gastrectomy, with respect to anastomotic leakage and bodyweight loss. The next step will be to conduct a prospective large cohort study.     

Gastric dysrhythmias and nausea of pregnancy

Gastric dysrhythmias have been recorded from patients with a variety of nausea syndromes. The aim of this study was to measure gastric myoelectric activity in women with and without nausea during the first trimester of pregnancy. In 32 pregnant women gastric myoeletric activity was recorded for 30-45 min with cutaneous electrodes that yielded electrogastrograms (EGGs). Frequencies of the EGG waves were analyzed visually and by computer. Subjects rated their nausea at the time of EGG recording on a visual analog scale with 0 representing no nausea and 300 mm severe nausea. Gastric dysrhythmias were found in 26 pregnant subject: Seventeen had tachygastrias (EGG frequencies of 4-9 cpm), five had 1- to 2-cpm EGG waves, and four had flat-line patterns Mean nausea scores of the subjects with tachygastrias, 1- to 2-cpm, and flat-line patterns were 64.8 +/- 13, 93.4 +/- 23, and 77.2 +/- 36, respectively. Six pregnant subjects had normal 3-cpm EGG patterns, and their nausea scores averaged 2.8 +/- 1.1 (P less than 0.05 compared with nausea scores in subjects with tachygastrias, 1- to 2-cpm, and flat-line rhythms). Six subjects with gastric dysrhythmias during pregnancy were restudied after delivery; each of these subjects had normal 3-cpm EGG patterns and none had nausea. Thus, gastric dysrhythmias are objective pathophysiologic events associated with symptoms of nausea reported during the first trimester of pregnancy.     

Gastric involvement in systemic sclerosis: a prospective study

OBJECTIVES: This study aims to assess the prevalence of gastric electrical activity dysfunction with cutaneous electrogastrography (EGG), disturbances of gastric emptying function using radiopaque pellets, and gastric endoscopic abnormalities in patients with systemic sclerosis (SSc). We also investigate for an association between EGG and gastric-emptying data with clinical manifestations and esophageal motor disturbances. METHODS: Fasting and postprandial gastric electrical activity was studied in 22 consecutive patients with SSc (17 with and 5 without clinical gastric manifestations) and 22 age- and sex-matched healthy subjects. Gastric emptying of radiopaque pellets and gastroscopy were also performed in SSc patients. RESULTS: The prevalence of EGG disturbances was as high as 81.82% in SSc patients. SSc patients exhibited, compared with controls, higher median percentage of dominant frequency in bradygastria during the fasting period and lower median values for postprandial electrical power and postprandial to fasting ratio for electrical power. Gastric emptying of radiopaque pellets was delayed in 11 SSc patients, and gastroscopy demonstrated "watermelon stomach" in 3 SSc patients. No correlation was found between the severity of gastric impairment and clinical presentation, SSc duration and subsets, and esophageal manometric impairment. CONCLUSIONS: Our study underlines the high frequency of gastric dysfunction in SSc patients. It suggests the usefulness of EGG in SSc in noninvasively detecting disorders of gastric electrical activity at an early stage and symptomatic patients with gastroparesis (because there was a correlation between values of postprandial to fasting ratio for electrical power of < 1 on EGG and delayed gastric emptying). Gastric-emptying evaluation of radiopaque pellets may further be a helpful method to depict symptomatic SSc patients with gastroparesis. Finally, our series confirms that watermelon stomach diagnosis should be excluded in SSc patients presenting with gastrointestinal hemorrhage or with anemia related to iron deficiency.     

Electrogastrography can recognize gastric electrical uncoupling in dogs

BACKGROUND & AIMS: Electrical uncoupling is the lack of electrical synchronization in different parts of the stomach. The ability of electrogastrography (EGG) to recognize gastric electrical uncoupling has not been adequately studied. The aim of this study was to determine the impact on EGG of surgically introduced gastric uncoupling in anesthesized dogs. METHODS: Six pairs of bipolar electrodes were inserted into the antral gastric wall of 16 anesthetized dogs at laparotomy. Eight-channel bipolar cutaneous EGGs were simultaneously recorded. Three separate half-hour recordings were made from each dog in the basal state and after each of two circumferential cuts of all gastric muscle. The stomach was divided into three equally sized areas, each with an electrode pair in its anterior and posterior walls. Gastric electrical activity was assessed visually. EGG was digitized and processed by computer. RESULTS: Criteria for EGG normality were defined from 9 dogs with normal gastric electrical activity. After the first antral cut, internal recordings from the area below the division were at a lower frequency and often irregular. The second cut produced three different frequencies. Suggested criteria for normality allowed correct recognition of 93% of all severely abnormal records. Records with mild gastric electrical abnormalities were recognized with a sensitivity of 74%. CONCLUSIONS: EGG can recognize severe electrical uncoupling. (Gastroenterology 1997 Jun;112(6):2006-11)     

Antral Myoelectric Activity,Gastric Emptying,and Dyspeptic Symptoms in Diabetics

Background: Electrogastrography (EGG) enables the cutaneous measurement of gastric electric activity. An association between electric abnormalities and gastrointestinal motility disorders has been shown. The primary objective of this study was to investigate whether diabetic gastroparesis could be predicted by EGG.

Methods: EGG was performed in 18 insulin-treated type-II diabetics (9 female, 9 male; median age, 64 years; range, 45-76 years) with chronic dyspepsia. After an overnight fast, during 1 h in the fasting and 1 h in the fed state after ingestion of a liquid-solid test meal (370 kcal; liquid phase labeled with 0.5 mCi ^99mTc-colloid) antral electric activity was captured by one pair of electrodes sonographically placed on the skin overlying the gastric antrum. Several EGG variables including dominant frequency (DF), percentages of DF in the normal range (24 cycles per minute (cpm)), bradygastria (<2cpm), and tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to preprandial power ratio (PR) were calculated by fast Fourier transform. The data were correlated to results obtained in 20 age- and gender-matched healthy subjects (10 female, 10 male; median age, 68 years; range, 53-90 years). In addition, the data were compared with the percentages of retention of the radionuclide in the stomach at 60 min, and lag times measured by simultaneous scintigraphy.

Results: The EGG values obtained in diabetics did not differ significantly from those in healthy subjects and did not correlate with radioscintigraphy (p > 0.05). Moreover, the EGG values in diabetics with delayed gastric emptying (about 40%) did not differ from data in diabetics without gastroparesis. Furthermore, whereas dyspepsia correlated significantly with radioscintigraphy, no correlation with EGG could be found.

Conclusions: Electrogastrography seems to be unsuitable for assessment of motility disorders in type4 diabetics.     

50例功能性消化不良患者空腹体表胃电图分析

目的：观察功能性消化不良患者空腹体表胃电图（EGC）变化情况。方法;对临床诊断为功能性消化不良的50例患者空腹体表EGG描记（实验组）。对照组为35例健康查体者,亦行空腹体表EGG描记,将两组描记结果进行对比分析。结果：50例功能性消化不良的患者中有38例（76％）体表EGG异常,主要表现为胃电节律过缓或过速。而对照组仅有5例（14．3％）体表EGG异常。两组差异显著（P＜0．05）。结论：空腹体表EGG描记对功能性消化不良具有协助诊断意义,它对进一步了解胃动力紊乱性疾病的病理机制亦有帮助。     

Gastric involvement in progressive systemic sclerosis: electrogastrographic and sonographic findings.

OBJECTIVE: To determine whether electrogastrography (EGG) can discern sonographically demonstrated motility disorders in patients with progressive systemic sclerosis (SSc) and to evaluate EGG as a possible diagnostic tool. DESIGN: Prospective study with control group and testing for reliability. SUBJECTS: 15 SSc patients [women aged 33-70 years (mean 53.3 years)] and 15 healthy volunteers. METHODS: Bipolar cutaneous EGG was recorded to obtain the following parameters: period dominant frequency (PDF), percentage of gastric dysrhythmia and normogastria (defined as 2-4/min), period dominant power (PDP) and its change after a standardized meal of 500 kcal (2093 kJ), and instability coefficients of dominant frequency and power (DFIC, DPIC). Simultaneously, real-time sonography was performed in the aortomesenteric plane (3.5-MHz curved-array probe). In 10 patients and 13 control subjects, the distance from the anterior wall of the gastric antrum to the abdominal skin was measured. RESULTS: Three patients (20%) showed hypomotility of the gastric antrum sonographically. The percentage of bradygastria was significantly lower in these patients, but the PDF, DFIC and DPIC values were not significantly different. The distance between the cutaneous electrodes and the antrum bore a greater relationship to the PDP values than did the sonographically demonstrated number of gastric contractions. CONCLUSIONS: Although cutaneous EGG can be performed in SSc patients without apparent derangement in frequency and stability of the signal, it offers no advantage over sonography in diagnosis and follow-up.     

Evaluation of Residual Stomach Motility After Proximal Gastrectomy for Gastric Cancer by Electrogastrography

The relationship between the motility and the size of the residual stomach after proximal gastrectomy was evaluated using electrogastrography (EGG). Based on fast Fourier transformation, recorded slow waves could be analyzed to obtain the following parameters: dominant frequency (DF), percentage normal frequency (% 3 cycles per minute [cpm]), and power ratio (PR). EGG parameters, the length of the greater curvature of the residual stomach (LGC), were recorded in 18 gastrectomized patients. Compared to 12 healthy controls, the gastrectomized patients had abdominal EGG parameters including lower %3cpm (43 ± 21% vs 83 ± 7%; P < 0.05), DF (2.2 ± 0.4 vs 3.0 ± 0.2 cpm; P < 0.05), and PR (1.5 ± 0.8 vs 2.5± 0.8; P < 0.05). In relation to LGC and parameters, there was no difference between the patients whose LGC was > 20 cm and controls in PR (2.3± 0.9 vs 2.5± 0.8; n.s.). In conclusion, the motility of the residual stomach would be equal to that of the nonresected stomach as if the volume of the residual stomach was more than half.     

胃食管反流病胃肌电活动的变化

目的 分析描述胃食管反流病(GERD)患者的胃肌电活动特点,探讨胃肌电活动的变化在GERD发病中的作用,以期有助于临床诊疗.方法 对65例GERD患者和30例健康志愿者进行餐前、餐后体表胃电图监测.根据内镜检查结果,把GERD患者分为反流性食管炎(RE)组、非糜烂性反流病(NERD)组,行组间胃电参数比较,随访19例胃电节律异常的GERD患者,观察治疗前后胃电参数的变化.结果 GERD组的主频(DF)正常慢波节律百分比(N%)、餐前餐后功率比(PR)与对照组相比明显降低(P<0.05或0.01).胃电节律紊乱,以胃动过缓为主.经1周治疗后,GERD异常胃电参数明显正常化(P<0.05或0.01).餐前RE组胃电节律异常的发生率(37.5%)显著高于NERD组(12.1%).餐后胃电节律异常的发生率RE组和NERD组分别为71.9%和60.6%,两者没有统计学意义(P>0.05).结论 GERD患者存在餐前、餐后胃肌电活动异常,异常胃电节律以胃动过缓节律为主,胃电图能为GERD诊断提供依据.     

Electrogastrographic characteristics in subjects with stomach remnant

Background and Aims: Slow wave (SW) is an essential component in mediating stomach motility. The purpose of the present study was to investigate the SW characteristics in subjects with stomach remnant. Methods: We consecutively enrolled 58 distal radical subtotal gastrectomy (RSG) patients (male/female: 44/14, age: 33–79 years) to receive an electrogastrographic (EGG) measurement. Their Helicobacter pylori status and dyspeptic score were simultaneously assessed. In addition, EGG data of 58 age‐ and sex‐matched healthy subjects were compared. Based on power spectral analysis, the following EGG parameters were derived: dominant frequency (DF)/power (DP), percentage of normal rhythm (2–4 cpm), power ratio (PR) referring the postprandial power change, etc. Results: Visual analysis occasionally found a short period of ～11 cpm myoelectricity‐like rhythm. Distal RSG patients had lower fasting (1.90 ± 0.69 vs 2.97 ± 0.58 cpm, P < 0.001) and postprandial (2.03 ± 0.72 vs 3.35 ± 0.27 cpm, P < 0.001) DF values, while their fasting (36.2 ± 22.3% vs 67.1 ± 23.4%, P < 0.001) and postprandial (33.4 ± 19.9% vs 82.2 ± 16.7%, P < 0.001) percentages of normal rhythms were diminished. In contrast, fasting DP, its meal response and PR (2.99 ± 2.40 vs 2.45 ± 2.63, NS) were comparable to those of controls. Neither gender, age, type of gastroenterostomy, Helicobacter pylori colonization, dyspeptic score nor elapsed time after surgery had an obvious influence on EGG parameters. Conclusions: Distal RSG patients may have decreased SW frequency and less meal ingestion changed EGG parameters in terms of SW frequency, normality and stability, whereas their EGG power remained unchanged irrespective of meal ingestion.