Electrogastrography: Poor correlation with antro-duodenal manometry and doubtful clinical usefulness in adults

Abstract

To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters. We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years. We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r=-0.07, P=0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7+/-0.5 vs 4.0+/-0.5) and tachygastric (3.5+/-0.4 vs 3.7+/-0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)]. EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.