20 Electrogastrography is of limited value in the diagnosis of motility disorders

Abstract

Background: Electrogastrography (EGG) is a technique for recording gastric myoelectric activity. Conflicting results were obtained in previous studies when EGG was applied in motility disorders of the stomach associated with various systemic diseases.Aim: To investigate whether the underlying diagnosis could be predicted from EGG parameters.Material and methods: This is a retrospective analysis of patients with motility disorders who underwent EGG as part of their clinical work‐up. A single bipolar channel measured the EGG. The ability of EGG to identify diagnostic groups was tested by comparing 21 EGG parameters for each diagnostic group or symptom against all other patients in the sample.Results: A total of 151 patients, 125 (83%) females, and mean age 45 ± 14 years were analysed. There were 52 patients with irritable bowel syndrome (IBS), 22 with enteric dysmotility, 26 with slow transit constipation (STC), 11 with chronic intestinal pseudo‐obstruction (CIP), 13 with gastroparesis or functional dyspepsia, three post‐surgical, and 24 patients with other diagnoses. In general, the discriminatory power of EGG for underlying motility disorder was low. Only those with STC showed a reasonable number of differences in EGG parameters compared to all other groups (Table). Patients with IBS had lower fasting and postprandial variability of the dominant frequency (DF) and a higher percentage of postprandial time with normogastric DF.Conclusion: The ability of EGG to identify motility disorders as well as symptoms in general was poor. EGG findings in patients with STC require validation. Significant EGG variables in slow transit constipation (STC) EGG parameter STC (n = 26) Other diagnosis (125) Postprandial normal power (Log) 3.7 ± 0.4 4.0 ± 0.5 Postprandial tachygastria power (Log) 3.5 ± 0.4 3.7 ± 0.4 Postprandial bradygastria% median and range 2 (0–20) 0 (0–17) Postprandial normal% median and range 87 (56–100) 96 (0–100) Postprandial tachygastria% median and range 9 (0–33) 3 (0–100) Postprandial DFIC% median and range 26 (8–72) 18 (2–77) Postprandial period dominant power PDP (Log) 2.1 ± 0.6 2.4 ± 0.5 Power Ratio (Log) 0.2 ± 0.5 0.4 ± 0.5