Abstract
Transcutaneous intraluminal impedance measurement (TIIM) is a new method to cutaneously measure gastric contractions by assessing the attenuation dynamics of a small oscillating voltage emitted by a battery-powered ingestible capsule retained in the stomach. In the present study, we investigated whether TIIM can reliably assess gastric motility in acute canine models. Methods. Eight mongrel dogs were randomly divided into 2 groups: half received an active TIIM pill and half received an identically sized sham capsule. After 24-hour fasting and transoral administration of the pill (active or sham), two force transducers (FT) were sutured onto the antral serosa at laparotomy. After closure, three standard cutaneous electrodes were placed on the abdomen, registering the transluminally emitted voltage. Thirty-minute baseline recordings were followed by pharmacological induction of gastric contractions using neostigmine IV and another 30-minute recording. Normalized one-minute baseline and post-neostigmine gastric motility indices (GMIs) were calculated and Pearson correlation coefficients (PCCs) between cutaneous and FT GMIs were obtained. Statistically significant GMI PCCs were seen in both baseline and post-neostigmine states. There were no significant GMI PCCs in the sham capsule test. Further chronic animal studies of this novel long-term gastric motility measurement technique are needed before testing it on humans.
Highlights
Distal postprandial gastric motility involves contractions that mechanically crush ingested food and mix it with secretions to prepare it for absorption, while maintaining an appropriate pressure gradient across the pyloric sphincter to regulate gastric emptying [1]
The aim of the present study was to evaluate the effectiveness of the minimally invasive, ingestible, gastric-retentive Transcutaneous intraluminal impedance measurement (TIIM) capsule for measuring gastric motility in comparison to a sham gastric-retentive, ingestible capsule, with both being referenced to force transducers attached to the serosa of the stomach in acute canine models [17]
In each animal the expanded pill was retrieved from the stomach at the end of the experiment, with an average postretrieval volume of 12.1 ± 0.4 mL and dimensions exceeding 1.5 cm in all directions, indicating that even the neostigmine-invoked contractions had not been able to Modality TIIM capsule Sham capsule
Summary
Distal postprandial gastric motility involves contractions that mechanically crush ingested food and mix it with secretions to prepare it for absorption, while maintaining an appropriate pressure gradient across the pyloric sphincter to regulate gastric emptying [1]. The two most prevalent gastric motility disorders are functional dyspepsia and gastroparesis, the cause and physiology of which are diverse [2] Both have similar symptoms, including upper abdominal pain, nausea, and early satiety, and can be associated with delayed gastric emptying [2, 3] which can make it difficult to distinguish between them clinically [2]. Both are chronic disorders that generate significant health care costs [4], and in both cases new approaches are needed for minimally invasive, long-term, ambulatory monitoring to potentially improve diagnosis and management.
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