A disturbance of the gastric myoelectric activity in post-operative patients with biliary atresia.

Abstract

Abnormalities in gastrointestinal motility have been reported in adult patients with advanced liver disease. However, there have so far been no reports on the gastric myoelectric activity in post-operative patients with biliary atresia (BA). The purpose of this study was to evaluate the gastric myoelectric activity in post-operative patients with BA in relation to liver fibrosis. Twenty-one post-operative patients with BA, consisting of 6 boys and 15 girls with a mean age of 8.0 years and 6 healthy children (control group) were included in the study. The gastric myoelectric activity was measured by electrogastrography (EGG). The patients with BA were divided into two groups according to the serum hyaluronic acid (HA) level as a marker of liver fibrosis: the fibrotic group (FG, n=11), HA>50 ng/ml and the non-fibrotic group (NF, n=10), HA <==50 ng/ml. All recorded data were spectrally analyzed and any parameters related to changes in the dominant peak frequency (DPF) and its power were investigated. Furthermore, the gastrointestinal symptom scores (GSS) were calculated in patients with dyspeptic symptoms according to the degree of advanced liver fibrosis. The results showed that 1) the postprandial DPF in the FG tended to be higher than that in the NFG ( p=0.051), 2) the postprandial variability index of the DPF in the FG and NFG were significantly higher than those in the controls ( p<0.05), and 3) the preprandial percentage of normal waves (PNW) in the FG tended to be lower than that in the controls ( p=0.089). The postprandial PNWs in the FG and NFG were significantly lower than those in the controls ( p<0.05). Especially, the postprandial PNW in the FG was significantly lower than that in the NFG ( p<0.05). 4) The power ratio in the FG and NFG were significantly lower than those in the controls ( p<0.05), and 5) the GSSs in the FG were significantly higher than those in the NFG ( p<0.05). The gastric myoelectric activity appeared to be disturbed in BA patients associated with portal hypertension and neurohormonal changes due to liver fibrosis.