Gastric Electrical Control Activity Research Articles

Disturbances of Gastric Electrical Control Activity after Laparotomic Cholecystectomy Are Related to Interleukin-6 Concentrations

Background: The aim of the present study was to characterize the disturbances of gastric electrical control activity after cholecystectomy and to correlate electrogastrographic (EGG) findings with inflammatory markers. Patients and Methods: 52 adult patients were examined in conjunction with planned laparotomic or laparoscopic cholecystectomy. Gastric myoelectrical activity was recorded with a MicroDigitrapper device using three Ag-AgCl disposable skin electrodes. The dominant frequency was calculated using computerized algorithms. Repeated EGG records were correlated with inflammatory parameters – interleukin-6 (IL-6), tumor necrosis factor-α, procalcitonin, and C-reactive protein. Results: Both basal and stimulated gastric electrical frequency decreased significantly in the postoperative phase measured 6 h after the start of surgery (p < 0.01). Postoperative bradygastria (electrical control activity frequency <2.4 cpm) was relatively more expressed after open cholecystectomy. Among the patients with a laparotomic cholecystectomy, IL-6 maximal postoperative concentrations correlated positively with a prolonged restitution of normal gastric activity. Conclusions: EGG examination showed a high sensitivity in the evaluation of gastric electrical activity after both laparotomic and laparoscopic cholecystectomy. A significant correlation of prolonged bradygastria and IL-6 plasma levels supports the role of the inflammatory milieu in the pathogenesis of impaired gastric electrical activity in the postoperative period.

A Barrier Kinetic Mapping Unit: Application to Ionic Transport in Gastric Smooth Muscle

A model has been developed to characterize the ionic basis of the shape of the electrical control activity (ECA) observed in gastric smooth muscle. The model uses barrier kinetics to describe the underlying ionic transport mechanisms responsible for the gastric ECA. The transmission coefficient parameter, which has been given little importance in the past, plays a major role in our model. It represents the gating and kinetics of the different channels. The model compares well with the Goldman-Hodgkin-Katz current equations for the sodium, calcium, and potassium channels. The model illustrates the importance of the calcium pump in maintaining the resting membrane potential and shows how the waveshape is influenced by the ratio of free to total intracellular calcium concentration. The effects of potassium accumulation and calcium on the waveform were also investigated. In the fundus of the stomach, where there are no voltage oscillations, the potassium channels were found to be more important than the other channels in maintaining the resting membrane potential.

Transcutaneous Electrogastrography in Patients with Ileus

Background: The aim of the prospective study was to characterize the disturbance of gastric electrical control activity in different types of ileus and to correlate surface electrogastrography (EGG) findings with a set of inflammatory markers. Patients and Methods: Fifty-four adult patients with mechanic, vascular and paralytic ileus proven on clinical and radiological exams and 14 age- and sex-matched controls were examined. Gastric myoelectrical activity was recorded using 3 Ag-AgCl disposable skin electrodes connected in pseudo-unipolar mode by Microdigitrapper device. The captured signal was amplified and digitalized. The dominant frequency was calculated using computerized algorithms (Fast Fourier transform and running spectrum analysis). The results were correlated with the known pathological diagnoses and 4 inflammatory parameters – interleukin (IL)-1β, IL-6, procalcitonin (PCT) and C-reactive protein. Results: Irregular EGG activity without a dominant frequency or bradygastria (electrical control activity frequency <2.4 cycles/min) was seen in all patients with both vascular and parayltic ileus and in 67.86% of the patients with obstructive ileus. Normogastria (2.4–3.7 cycles/min) was found in 32.14% of the patients with obstructive ileus. Among the patients with obstructive ileus and bradygastria, higher concentrations of IL-6 (642.0 ± 214.7 ng/l) and PCT (0.93 ± 0.22 µg/l) were observed compared with the patients with normogastria – IL-6 (354.5 ± 109.2 ng/l), PCT (0.69 ± 0.11 µg/l); p < 0.05 for both. The C-reactive protein concentration did not differ in both subgroups on p < 0.05. Conclusions: EGG examination confirmed a high sensitivity in the evaluation of gastric electrical control activity in both vascular and paralytic ileus. Significant correlation of EGG findings and both IL-6 and PCT plasma levels supports a role of the inflammatory milieu in the pathogenesis of impaired gastric electrical activity in patients with ileus.

Artifact reduction in magnetogastrography using fast independent component analysis

The analysis of magnetogastrographic (MGG) signals has been limited to epochs of data with limited interference from extraneous signal components that are often present and may even dominate MGG data. Such artifacts can be of both biological (cardiac, intestinal and muscular activities, motion artifacts, etc) and non-biological (environmental noise) origin. Conventional methods—such as Butterworth and Tchebyshev filters—can be of great use, but there are many disadvantages associated with them as well as with other typical filtering methods because a large amount of useful biological information can be lost, and there are many trade-offs between various filtering methods. Moreover, conventional filtering cannot always fully address the physicality of the signal-processing problem in terms of extracting specific signals due to particular biological sources of interest such as the stomach, heart and bowel. In this paper, we demonstrate the use of fast independent component analysis (FICA) for the removal of both biological and non-biological artifacts from multi-channel MGG recordings acquired using a superconducting quantum intereference device (SQUID) magnetometer. Specifically, we show that the signal of gastric electrical control activity (ECA) can be isolated from SQUID data as an independent component even in the presence of severe motion, cardiac and respiratory artifacts. The accuracy of the method is analyzed by comparing FICA-extracted versus electrode-measured respiratory signals. It is concluded that, with this method, reliable results may be obtained for a wide array of magnetic recording scenarios.

An anatomical model of the gastric system for producing bioelectric and biomagnetic fields

Between 60 and 70 million people in the United States are affected by gastrointestinal disorders. Many of these conditions are difficult to assess without surgical intervention and accurate noninvasive techniques to aid in clinical assessment are needed. Through the use of a superconducting quantum interference device (SQUID) gradiometer, the weak magnetic field generated as a result of muscular activity in the digestive system can be measured. However, the interpretation of these magnetic recordings remains a significant challenge. We have created an anatomically realistic biophysically based mathematical model of the human digestive system and using this model normal gastric electrical control activity (ECA) has been simulated. The external magnetic fields associated with this gastric ECA have also been computed and are shown to be in qualitative agreement with recordings taken from normal individuals. The model framework thus provides a rational basis from which to begin interpreting magnetic recordings from normal and diseased individuals.

Theoretical ellipsoidal model of gastric electrical control activity propagation.

A theoretical model of electric current propagation in the human stomach is developed using an approach in which the shape of the organ is assumed to be a truncated ellipsoid whose dimensions can be determined from anatomic measurements. The gastric electrical activity is simulated using a ring of isopotential electric current dipoles that are generated by a pacemaker situated in the gastric corpus. The dipoles propagate in the direction of the pylorus at a frequency of three cycles per minute. The advantages of employing ellipsoids in the analytical formulation of this gastric model are discussed in addition to the realism and usefulness of the approach.

Electrogastrography in gastrostomy-tube-fed children.

Following gastrostomy tube placement some children develop gagging, retching, vomiting, pain, or irritability during feedings. Conventional medical management is not always successful. It is possible that intolerance of gastrostomy tube feedings reflects an underlying motility disorder of the foregut. The study aim was to determine whether children with gastrostomy tube feeding difficulties demonstrate abnormal gastric electrical control activity as measured by electrogastrography. Cutaneous electrogastrography of interpretable quality was performed in 25 feeding-tolerant and 23 feeding-intolerant children less than 10 years of age. Dominant frequencies, rhythm indices, and postprandial power measurements were recorded during the fasting and postprandial periods. Differences between groups were compared using the Student's t test. The groups were similar in method of gastrostomy tube placement, antireflux surgery, neurological impairment, duration of gastrostomy feeding dependence, formula type, volume, and administration. The feeding-tolerant group was significantly older (P<0.01). There were no significant differences between groups in the mean dominant frequencies or rhythm indices. The feeding-intolerant children had a mean postprandial power change that was significantly lower than that of the feeding tolerant group (P<0.003), although overlap was present. Children who are intolerant of gastrostomy tube feeding have an abnormal postprandial power decrease. EGG dominant frequency and rhythm indices are not predictive of gastrostomy feeding tolerance in predominantly neurologically impaired children.

Nissen fundoplication may induce gastric myoelectrical disturbance in children

Background: Recurrent vomiting with failure to thrive is a common problem in neurologically impaired children. Many undergo fundoplication to control the underlying gastroesophageal reflux, but the results of surgery are not always satisfactory, and postoperative retching may be a major problem. Retching is part of the emetic reflex and is associated with nausea, which is itself associated with disturbed gastric electrical control activity, resulting in a gastric dysrhythmia. Methods: By recording gastric electrical control activity before and after Nissen fundoplication using the noninvasive technique of surface electrogastrography, the authors have shown that (1) Neurologically impaired children with gastroesophageal reflux more commonly have a preexisting gastric dysrhythmia (65% neurologically impaired v 20% neurologically normal children with gastroesophageal reflux, P < .05), (2) Children who retch preoperatively are three times more likely to retch postoperatively, and (3) 25% of neurologically impaired children may start to retch postoperatively for the first time. Conclusion: The authors propose that in neurologically impaired children, loss of central inhibitory mechanisms may result in inappropriate activation of the emetic reflex, which may be heightened by antireflux surgery.

Electrogastrography after operative repair of esophageal atresia.

Esophageal atresia (EA) is a life-threatening disorder associated with operative complications. Postoperative gastric electrical control activity detected by a non-invasive electrogastrography (EGG) technique was investigated in 13 children aged 1-17 years to clarify whether gastric motility disorders were present. EGG abnormalities were present in 5 patients; persistent dysrhythmias were found in 3. Roentgenographic examinations showed mild gastroesophageal reflux in 3 (60%) of the dysrhythmic patients; 2 others had postprandial dysrhythmias. The mean spectral frequency (MSF) of EA cases with dysrhythmia was significantly higher than that of patients without dysrhythmia in both fasting and postprandial states (P < 0.05). The variability of the peak spectral frequencies (PSFV) in patients with dysrhythmia was significantly higher than in those without dysrhythmia in both fasting and postprandial states (P < 0.05). There were no significant differences in MSF and PSFV between EA patients without dysrhythmia and controls. These results suggest that gastric motor activity may be disordered in patients following operative repair of EA, although they remain asymptomatic. EGG may be a useful screening examination for postoperative gastric functional disorders.

NON-INVASIVE ASSESSMENT OF GASTRIC MOTILITY AND GASTRIC EMPTYING IN VOMITING CHILDREN WITH DISORDERS OF THE CENTRAL NERVOUS SYSTEM.

Vomiting and feeding problems are common in children with disorders of the central nervous system (CNS) and may be related to a disordered motility of the foregut. The conventional tools for assessing foregut motility are either invasive (e.g. pH monitoring and manometry) or very expensive and time-consuming (e.g. scintigraphy) and therefore they are not ideal for general use in neurologically handicapped infants and children. We studied gastroesophageal motor function in 50 vomiting patients with CNS disorders, 25 boys and 25 girls (age range: 4 months - 15.5 years), 38 with neurodevelopmental delay and 12 with spastic cerebral palsy. The novel non-invasive techniques of electrogastrography (EGG) and electrical impedance tomography (EIT) were used to investigate respectively the fasting and postprandial gastric antral electrical control activity that underlies antral contractions and the gastric emptying of a standard milk meal. In most cases, EGG and EIT were carried out simultaneously after an overnight fast at the bedside or while the patients were sitting in their wheelchairs. All tests were very well tolerated, and in some patients the tests were repeated after medical or surgical treatment. In 31 of 50 vomiting patients EGG detected abnormalities of gastric antral electrical control activity, with different dysrrhythmias: tachyarrhythmia at >5 cpm, bradyarrhythmia at <2 cpm, or unstable electrical activity where no dominant frequency could be detected (controls: 2.2 to 4.0 cpm). EIT showed that the gastric half-emptying time (T½) of a milk meal was delayed in 14 of 18 patients, 13 of whom also had a gastric dysrhythmia and 8 of whom also had gastroesophageal reflux. Gastric dysrryhtmias and/or delayed gastric emptying were also demonstrated in the majority (72%) of patients who had retching and postprandial discomfort following anti-reflux surgery. Furthermore, EIT showed evidence of gastroesophageal reflux in 12 of 13 patients who had reflux on pH monitoring. Being non-invasive, relatively cheap, portable and easy to use, EGG and EIT can be used for the routine assessment of gastrointestinal motility in infants and children with neurodevelopmental handicap. The informations they provide can help the carers to devise better nutritional and pharmacological strategies for the management of vomiting and feeding problems which are frequently encountered in these patients.

Electrogastrography in chronic intestinal pseudoobstruction

This study aimed to characterize the disturbance of gastric electrical control activity in chronic intestinal pseudoobstruction (CIP) and to determine whether surface electrogastrography (EGG) could be used to diagnose the presence and type of CIP. Gastric electrical control activity was recorded for 30 min in each of the fasting and fed states by EGG in 14 adults with CIP proven on clinical, radiological, and histological grounds, and in 14 age- and sex-matched controls. Electrical activity was recorded from four pairs of Ag-AgCl bipolar skin electrodes, the captured signal amplified and digitalized, and running spectral analysis performed. The dominant frequency and power of spectrum were calculated using a sequence of computerized algorithms. Results were correlated with the known pathological diagnoses [visceral myopathy (M), N = 7; visceral neuropathy (N), N = 4; undifferentiated (U), N = 3]. Dysrhythmias were present in 13 of 14 patients. Tachygastria (electrical control activity frequency >5 cycles/minute) and a normal amplitude response to food, was seen in five patients (N = 4, U = 1). Irregular continuous activity without a dominant frequency or bradyarrhythmia, together with a diminished electrical response activity (ERA) to food, were found in six patients (M = 5, U = 1). Mixed abnormalities were seen in two patients (M = 1, U = 1), and normal activity with a clear dominant frequency of 3 cycles/minute was present in only one patient (M = 1). This noninvasive technique is both sensitive and specific in providing evidence of a dysrhythmia in patients with CIP and discriminates between primary pathologies. EGG may prove diagnostically useful in these disorders and may provide insight into the disturbance of electrical control activity.

Gastric myoelectrical activity and gastrointestinal motility in patients with functional dyspepsia.

The aim of our study was to examine the prevalence of gastric myoelectrical disturbances in relation to gastrointestinal motility abnormalities in patients with functional dyspepsia, using simultaneous electrogastrography and antroduodenojejunal manometry. We carried out electrogastrography in 20 patients with functional dyspepsia and in 20 healthy volunteers. In 10 of these patients and in 10 of the volunteers antroduodenojejunal manometry was performed simultaneously. Apart from a higher postprandial power content of the 3 cycles per minute (cpm) component in the patients (1263 +/- 317 and 393 +/- 101 microV2, respectively; P = 0.016), no differences in the electrogastrographic variables were found between the groups. In the manometric part of the study, postprandial antral hypoactivity was not a prominent finding. Instead, small intestinal hyperactivity was found in the dyspeptic patients, with both a higher frequency and amplitude of the contractions (P < 0.05). This hyperactivity often consisted of bursts, which were significantly more frequent in patients than in control subjects (total duration of burst activity 25.6 +/- 6.4 and 6.0 +/- 1.7 min, respectively; P = 0.013). A positive correlation was found between the frequency of the gastric electrical control activity and the antral contraction frequency (P = 0.006), between the power content of the electrographic signal and the antral contraction amplitude (P = 0.025), and between the postprandial/fasting electrographic power ratio and the antral motility index (P = 0.007). In conclusion, gastric myoelectrical activity is minimally disturbed in patients with functional dyspepsia. Motor abnormalities, especially small intestinal hyperactivity, are more likely to play a prominent role in the genesis of dyspeptic symptoms.

Effects of chronic vitamin E deficiency on gastric electrical control activity in the rat

Effects of chronic vitamin E deficiency on gastric electrical control activity in the rat

Gastric emptying in children with gastric transposition.

Using the noninvasive technique of electrical impedance tomography (EIT), gastric emptying was studied in 12 children, aged 9 months to 17 years, who had undergone gastric transposition (six with pyloroplasty) for oesophageal replacement (seven oesophageal atresia, five severe caustic or peptic damage). In two patients, gastric antral electrical control activity was also studied using surface electrogastrography. Nine patients had problems on oral feeds (respiratory symptoms, feeding difficulties, vomiting, abdominal pain, symptoms suggesting dumping), whilst three were asymptomatic. All 12 patients were tested with a milk meal; in addition four (two with and two without dumping symptoms) were tested with a hypertonic glucose drink; gastric emptying of the milk meal was expressed as the percentage of the meal remaining in the stomach at 60 min (R60). Mean (+/- 2 SD) R60 was 54.6% (+/- 17.4%) in 12 healthy controls and 59.8% (+/- 83.2%) in the 12 patients. Gastric emptying was normal in one patient (R60, 42.6%), delayed in seven (mean R60, 91.2%; range, 74.4-100%), and accelerated in four (R60, 0%). The emptying rate was unrelated to the presence or absence of pyloroplasty. Furthermore, the emptying pattern was extremely irregular, suggesting that gastroesophageal as well as duodenogastric reflux episodes occurred in all patients. The hypertonic glucose drink induced dumping (50% of the meal emptied at 1-3 min) in all four patients, two of whom had delayed emptying of the milk meal, but the gastric antral electrical control activity occurred at the normal frequency of 0.05 Hz.(ABSTRACT TRUNCATED AT 250 WORDS)

Gastric Emptying in Children with Gastric Transposition

SummaryUsing the noninvasive technique of electrical impedance tomography (EIT), gastric emptying was studied in 12 children, aged 9 months to 17 years, who had undergone gastric transposition (six with pyloroplasty) for oesophageal replacement (seven oesophageal atresia, five severe caustic or peptic damage). In two patients, gastric antral electrical control activity was also studied using surface electrogastrography. Nine patients had problems on oral feeds (respiratory symptoms, feeding difficulties, vomiting, abdominal pain, symptoms suggesting dumping), whilst three were asymptomatic. All 12 patients were tested with a milk meal; in addition four (two with and two without dumping symptoms) were tested with a hypertonic glucose drink; gastric emptying of the milk meal was expressed as the percentage of the meal remaining in the stomach at 60 min (R60). Mean (±2 SD) R60 was 54.6% (±17.4%) in 12 healthy controls and 59.8% (±83.2%) in the 12 patients. Gastric emptying was normal in one patient (R60, 42.6%), delayed in seven (mean R60, 91.2%; range, 74.4–100%), and accelerated in four (R60, 0%). The emptying rate was unrelated to the presence or absence of pyloroplasty. Furthermore, the emptying pattern was extremely irregular, suggesting that gastroesophageal as well as duodenogastric reflux episodes occurred in all patients. The hypertonic glucose drink induced dumping (50% of the meal emptied at 1–3 min) in all four patients, two of whom had delayed emptying of the milk meal, but the gastric antral electrical control activity occurred at the normal frequency of 0.05 Hz. The transposed stomach does not behave as a simple conduit; in most cases it retains its reservoir function. Irrespective of the patient's symptoms, the transposed stomach empties in an abnormal fashion, and the composition of the meal may considerably affect the emptying pattern.

Gastric myoelectrical activity in patients with type I diabetes mellitus and autonomic neuropathy

In patients with diabetes mellitus and gastroparesis, dysrhythmias of gastric myoelectrical activity, especially tachygastrias, are thought to be involved in the pathogenesis of dyspeptic symptoms. Using surface electrogastrography we studied the prevalence of these abnormalities, and their relationships to dyspeptic symptoms and the extent of cardiac autonomic neuropathy in 30 euglycemic patients with type I diabetes mellitus and 12 controls. Neither in the fasting nor in the postprandial state were differences in mean frequency of gastric electrical control activity and its variability found between patients and controls. In the fasting state, the power content of the 3 cpm component in the power spectrum of the electrogastrogram was even higher in patients than in controls (P = 0.049). In the fasting state, second harmonics of the 3 cpm fundamental gastric signal were seen more often in patients than in controls (P = 0.03). In patients with symptoms during the study, no second harmonics were found after the meal. The postprandial/fasting power ratio was decreased in patients with symptoms during the study as compared to patients without symptoms and controls (P < 0.05). The incidence of dysrhythmias, such as tachygastrias and bradygastrias, was not higher in patients than in controls (17% and 8%, respectively). No correlation was found between electrogastrographic parameters and the severity of autonomic neuropathy or dyspeptic symptoms scored before the study. In conclusion, this study has shown that patients with type I diabetes mellitus and autonomic neuropathy studied under euglycemic conditions do not have grossly disturbed myoelectrical activity, except when symptomatic during the study.

Normal gastric antral myoelectrical activity in early onset anorexia nervosa.

Anorexia, epigastric discomfort, nausea, and vomiting may result from disordered gastric motility and emptying. These features have been found in many adults with anorexia nervosa, but have never been investigated in early onset anorexia nervosa. In 14 patients with early onset anorexia nervosa (eight of whom had upper gastrointestinal tract symptoms), six children with other eating disorders, four children with non-ulcer dyspepsia, and 10 controls matched for age and sex, the non-invasive technique of surface electrogastrography was used to measure fasting and postprandial gastric antral electrical control activity, which underlies antral motility. The electrical signal was recorded by four bipolar silver/silver chloride electrodes attached to the upper abdomen, amplified and low pass filtered at 0.33 Hz before being displayed on a polygraph, digitised at 1 Hz, and stored on the hard disk of a personal computer for later offline analysis. Patients with non-ulcer dyspepsia had gastric antral dysrhythmias. No significant difference was found in the mean (SD) dominant frequency of the antral electrical control activity between patients with early onset anorexia nervosa (2.86 (0.35) cycles/minute (cpm)), patients with other eating disorders (3.14 (0.65) cpm), and controls (3.00 (0.46) cpm). The amplitude of electrical control activity increased postprandially in all but one subject and the fasting/postprandial amplitude ratio did not significantly differ between patients with early onset anorexia nervosa and controls, though patients with longer established disease had a smaller increase in amplitude. Gastric antral electrical dysrhythmias are not a feature of early onset anorexia nervosa and therefore do not induce or perpetuate food refusal in this disorder.

Effect of cimetidine and ranitidine on gastric electrical activity in man.

Electrical activity was recorded in six post-cholecystectomy patients using bipolar serosal electrodes. Three patients were treated with intravenous cimetidine bolus in doses of 200 mg every four hours. Another three patients were treated with intravenous ranitidine bolus in doses of 50 mg every six hours. The frequency and the amplitude of the gastric electrical control activity (ECA) and the incidence of electrical response a activity (ERA) were evaluated before and after the administration of the drugs. The administration of cimetidine and ranitidine did not produce any statistically significant variation in the frequency and amplitude of the gastric ECA and the incidence of ERA. These results show that the effects of the H2-antagonists on gastric electrical activity had no clinical relevance.

Foregut motor function in chronic renal failure.

In children with chronic renal failure (CRF) anorexia, nausea, and vomiting are common yet poorly understood symptoms. We studied oesophageal and gastric motor function in 12 children (age 7 months-6.8 years) with severe CRF not undergoing dialysis who had persistent anorexia and vomiting. Eight of 12 patients had significant gastro-oesophageal reflux (reflux index 5.2% to 21.9%, mean 11.3%; controls < 5%), 7/10 had altered gastric half emptying times (T1/2) for 5% glucose or milk (glucose meal--controls: 8-14 min, two CRF patients: 18-25 min; milk meal--controls: 48-72 min, five CRF patients 27, 28, 82, 83, and 110 min). Gastric antral electrical control activity was abnormal in 6/11 patients, with different types of gastric dysrhythmias whereas the remainder and controls showed a regular dominant frequency of 0.05 Hz. In 7/9 patients fasting serum gastrin concentration was raised (53 to > 400, mean 168 pmol/l, controls < 40 pmol/l). All CRF patients with anorexia and vomiting had one or more disorder of foregut motility. The nature and variety of the motor disorders and the raised concentrations of circulating gastrin suggest that the normal environment generated by CRF affects the function of the smooth muscle of the foregut.

Gastric antral dysrhythmias in children with chronic idiopathic intestinal pseudoobstruction.

Chronic idiopathic intestinal pseudoobstruction is a serious disorder of intestinal neuromuscular function resulting in recurrent episodes of intestinal obstruction, and is caused by primary disease of the enteric nerves or enteric smooth muscle. Gastric electrical control activity detected by the non-invasive technique of surface electrogastrography was investigated in 11 children (0.1-16 years) with proven chronic idiopathic intestinal pseudoobstruction (four with known disease of the enteric nerves, three with disease of smooth muscle cells, and four without defined pathology), to determine whether abnormalities were present and whether these were useful in detecting the underlying pathology. Abnormalities were present in eight of 11 patients. Persistent tachygastria (electrical control activity frequency > 5 cycles/minute) was found in three patients, all with a proven neuropathy. A continuously irregular frequency was found in five patients, three with a proven myopathy and two with undefined pathology. A normal electrical control activity frequency was present in three patients, one with a proven neuropathy and two with undefined pathology. It is suggested that this non-invasive technique may provide a useful screening test of the pathophysiological basis of the functional obstruction in children with chronic idiopathic intestinal pseudoobstruction.