17 Multi‐channel electrogastrography (MEGG), gastric dysmotility and duodenal dysmotility in patients with functional dyspepsia: a self‐control study

Abstract

Abnormalities in gastric slow waves and motility are frequently reported in functional dyspepsia patients. However, simultaneous assessment of the slow wave and motility abnormalities has rarely been done.The aim of this study is to assess gastric slow waves and antroduodenal motility simultaneous and determine the correlation among all measures in patients with functional dyspepsia.Methods: Thirty‐one patients (8 M, 23 F, mean age 48.7, Range (23–79) with functional dyspepsia were assessed for severity of upper gastrointestinal symptoms, the multi‐channel electrogastrogram (MEGG) and antroduodenal manometry. The MEGG and manometry were recorded for 3–4 hours in the fasting state and for two hours after a solid meal. Computerized spectral analysis methods were utilized to compute the following MEGG parameters in the fasting and fed state. Dominant frequency, Dominant power and % of 2–4 cycles min­1 slow waves. Common gastrointestinal symptoms of nausea, vomiting, upper abdominal pain, bloating, early satiety and etc. were assessed for symptom severity and graded.Results: (1) The MEGG was abnormal in 71.0% of patients. The abnormalities included normal slow waves lower than 70% in fasting state (51.6% of patients) and in fed state (48.4% of patients), a decrease in dominant power in 28.9% of patients. (2) Antral motility was abnormal in 83.9% and duodenal motility was abnormal in 74.2% of patients. There was a significant correlation between these two abnormalities. (3) For the MEGG and antral motility, 19 of 31 patients had both abnormal MEGG and abnormal antral motility; two of 31 patients had both normal MEGG and normal antral motility. For the MEGG and duodenal motility, these values were 16/31 and 2/31 respectively. (4) The patients showed high symptom scores particularly to upper abdominal pain, nausea and belch, with an average symptom score of 2.5/4 for pain, 2.5/4 for nausea and 2.3/4 for belch, respectively. The mean total score was 22/52 for all symptoms. (5) No significant correlation was noted between the symptom scores and any of the MEGG or motility parameters.Conclusions: More than two thirds of patients with functional dyspepsia have abnormalities in the MEGG and antral duodenal motility. The sensitivity of these two different methods is essentially the same. Abnormalities in gastric motility and duodenal motility are correlated whereas the symptoms are not correlated with any of the MEGG or motility parameters.