Abstract
Gastric myoelectrical activity modulates gastric motor activity. Abnormalities in gastric myoelectrical activity may be associated with gastric motility disorders. The aim of this study was to investigate the correlation of gastric myoelectrical activity with gastric emptying in symptomatic patients with and without gastroparesis. Ninety-seven patients with symptoms suggestive of gastroparesis participated in the study. Gastric myoelectrical activity was recorded using surface electrogastrography. The electrogastrogram (EGG) was recorded for 30 min in the fasting state and for 120 min after a solid test meal. Gastric emptying of the solid meal was simultaneously monitored for 120 min. Patients with delayed gastric emptying showed a significantly lower percentage of normal gastric slow waves (P<0.03) and a significantly reduced increase of the dominant power in the postprandial EGG (P<0.02). Postprandial EGG parameters were found to be able to predict delayed emptying of the stomach. Postprandial gastric dysrhythmia predicts delayed gastric emptying with an accuracy of 78%, while the abnormality in postprandial EGG power predicts delayed gastric emptying with an accuracy of 75%. All patients with abnormalities in both the rhythmicity and the power had delayed gastric emptying. Patients with delayed gastric emptying have a lower percentage of normal gastric slow waves in the EGG and a lower postprandial increase in the dominant power. Abnormalities in the postprandial EGG seem to be able to predict delayed emptying of the stomach. However, a normal EGG does not seem to guarantee normal emptying of the stomach.
Similar content being viewed by others
References
Hinder RA, Kelly KA: Human gastric pacesetter potential. Site of origin, spread and response to gastric transection and proximal gastric vagotomy. Am J Surg 133:29–33, 1978
Kelly KA, Code CF, Elveback LR: Patterns of canine gastric electrical activity. Am J Physiol 217:461–470, 1969
Sarna SK: Gastrointestinal electrical activity; terminology. Gastroenterology 68:1631–1635, 1975
Smout AJPM, van der Schee EJ, Grashuis JL: What is measured in electrogastrography? Dig Dis Sci 25:179–187, 1980
Abell TL, Malagelada J-R: Glucagon-evoked gastric dysrhythmias in humans shown by an improved electrogastrographic technique. Gastroenterology 88:1932–1940, 1985
Hamilton JW, Bellahsene B, Reichelderfer M, Webster JG, Bass P. Human electrogastrograms: Comparison of surface and mucosal recordings. Dig Dis Sci 31:33–39, 1986
Familoni BO, Bowes KL, Kingma YJ, Cote KR: Can transcutaneous recordings detect gastric electrical abnormalities? Gut 32:141–146, 1991
Chen J, Schirmer BD, McCallum RW: Serosal and cutaneous recordings of gastric myoelectrical activity in patients with gastroparesis. Am J of Physiol 266:G90-G98, 1994
Chen J, Richards RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroenterol 89:79–85, 1994
Bortolotti M, Sarti P, Barara L, Brunelli F: Gastric myoelectric activity in patients with chronic idiopathic gastroparesis. J Gastrointest Motil 2:104–108, 1990
Code CF, Marlett JA: Modern medical physiology: Canine tachygastria. Mayo Clin Proc 49:325–332, 1974
Kim CH, Zinsmeister AR, Malagelada JR: Effect of gastric dysrhythmias on postcible motor activity of the stomach. Dig Dis Sci 33:193–199, 1988
Kim CH, Hanson RB, Abell TL, Malagelada J-R: Effect of inhibition of prostaglandin synthesis on epinephrine-induced gastroduodenal electromechanical changes in humans. Mayo Clin Proc 64:146–157, 1989
Stoddard CJ, Smallwood RH, Duthie HL: Electrical arrhythmias in the human stomach. Gut 22:705–712, 1981
Telander RL, Morgan KG, Kreulen DL, Schemalz PF, Kelly KA, Szurszewki JH: Human gastric atony with tachygastria and gastric retention. Gastroenterology 75:495–501, 1978
You CH, Chey WY, Lee KY, Menguy Y, Bortoff A: Gastric and small intestinal myoelectrical dysrhythmia associated with chronic intractable nausea and vomiting. Ann Intern Med 95:449–451, 1981
You CH, Lee KY, Chey WY, Menguy R: Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 79:311–314, 1980
Cucchiara S, Riezzo G, Minella R, Vallone G, Vallone PF, Giorgio I, Auricchio S: Electrogastrography in nonulcer dyspepsia. Arch Dis Child 67:613–617, 1992
Geldof H, Van der schee EJ, Smout AJPM, Van de merwe JP, Van blankenstein M, Grashuis JL: Myoelectrical activity of the stomach in gastric ulcer patients: An electrogastrographic study. J Gastrointest Motil 1:122–130, 1989
Koch KL, Stern RM, Stewart WR, Vasey MW: Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: Effect of long-term domperidone treatment. Am J Gastroenterol 84:1069–1075, 1989
Stern RM, Kenneth LK, Leibowitz HW, Lindblad IM, Shupert CL, Stewart WR: Tachygastria and motion sickness. Aviat Space Environ Med 56:1074–1077, 1985
Ravelli AM, Spits L, Milla PJ: Gastric emptying in children with gastric transposition. J Pediatr Gastroenterol Nutr 19:403–409, 1994
Sun WM, Smout A, Malbert C, Edelbroek MAL, Jones K, Dent J, Horowitz M: Relationship between surface electrogastrography and antropyloric pressure. Am J Physiol 31:G424-G430, 1995
Hasler WL, Soudah HC, Dulai G, Owyang C: Mediation of hyperglycemia-evoked gastric slow wave dysrhythmias by endogenous prostaglandin. Gastroenterology 108:727–736, 1995
Chen J, McCallum RW: Gastric slow wave abnormalities in patients with gastroparesis. Am J Gastroenterol 87:477–482, 1992
Chen J: A computerized data analysis system for electrogastrogram. Comp Biol Med 22:45–58, 1992
Chen J, Stewart WR, McCallum RW: Spectral analysis of episodic rhythmic variations in the cutaneous electrogastrogram. IEEE Trans Biomed Eng 40:128–135, 1993
Nelsen TS, Kohatsu S: Clinical electrogastrography and its relationship to gastric surgery. Am J Surg 116:215–222, 1968
Koch KL, Stewart WR, Stern RM: Effect of barium meals on gastric electromechanical activity in man. Dig Dis Sci 32:1217–1222, 1987
Abell TL, Camilleri M, Hench VS, Malagelada J-R: Gastric electromechanical function and gastric emptying in diabetic gastroparesis. Eur J Gastroenterol Hepatol 3:163–167, 1991
Geldof H, van der Schee EJ, Grashuis JL: Electrogastrographic characteristics of interdigestive migrating complex in humans. Am J Physiol 250:G165-G171, 1986
van der Schee ET, Grashuis JL: Contraction-related, low-frequency components in canine electrogastrographic signals. Am J Physiol 245:G470-G475, 1983
Geldof H, van der Schee EJ, Van Blankenstein M, Grashius JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 26:799–808, 1986
Rothstein RD, Alavi A, Reynolds JC: Electrogastrography in patients with gastroparesis and effect of long-time cisapride. Dig Dis Sci 38:1518–1524, 1993
Desvarannes SB, Mizafi M, Dubois A: Relation between post-prandial gastric emptying and cutaneous electrogastrogram in primates. Am J Physiol 261:G248-G255, 1991
Schwarts HJ, Whitehead WE, Schuster MM: Comparison of electrogastrogram and gastric emptying studies in patients with suspected motility disorders. Gastroenterology 102:A510, 1992 (abstract)
Hongo M, Okuno Y, Yamada M, Nishimura N, Toyota T: Gastric emptying and electrogastrogram. Gastroenterology 102:A459, 1992 (abstract)
Nemoto D, Abell TL, Cardoso S, Familomi BO, Fisher J, Portera F: Elevated dopamine levels associated with impairment of sympathetic adrenergic function in diabetic gastroparesis. Gastroenterology 102:A492, 1992 (abstract)
Satake M, Hongo M, Fukudo S, Nomura T, Shoji T: Postprandial increase in electrogastrogram (EGG) power and the distance between the gastric and the abdominal wall. Proc 3rd Intl Workshop on Electrogastrography, San Diego, May, 1995, p 44 (abstract)
Lin ZY, Chen JDZ, McCallum RW, Schirmer BD: Postprandial amplitude changes in electrogastrogram accurately reflect changes of gastric slow waves. Neurogastroenterology 7:269, 1995 (abstract)
Chen J, Davenport K, McCallum RW: Effect of fat preload on gastric myoelectrical activity in normal humans. J Gastrointest Motil 5:281–287, 1993
Chen J, Lin ZY, Parolisi S, McCallum RW: Inhibitory effects of cholecystokinin on postprandial gastric myoelectrical activity. Dig Dis Sci 40:2614–2622, 1995
Chen J, McCallum RW (eds) Electrogastrography: Principles and Applications. New York, Raven Press, 1995
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chen, J.D.Z., Lin, Z., Pan, J. et al. Abnormal gastric myoelectrical activity and delayed gastric emptying in patients with symptoms suggestive of gastroparesis. Digest Dis Sci 41, 1538–1545 (1996). https://doi.org/10.1007/BF02087897
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02087897