Intragastric maldistribution of a liquid meal in patients with reflux oesophagitis assessed by three dimensional ultrasonography

Abstract

Background and aims: Our aim was to study intragastric volume and distribution of a liquid meal in patients with reflux oesophagitis using three dimensional ultrasonography. Methods: Twenty patients and 20 healthy controls underwent ultrasonographic measurements of the stomach using a position sensor based on magnetic scanhead tracking for acquisition of three dimensional images. In vivo accuracy of the method was evaluated by scanning a soup filled barostat bag positioned in the proximal stomach of six healthy subjects. Results: In the volume range 100-700 ml, our three dimensional system showed excellent correlation (r=0.99) between estimated and true volumes (limits of agreement −3.4 to 11.0 ml) and a low interobserver variation (limits of agreement −10.9 to 6.7 ml). After ingestion of a 500 ml meat soup meal, patients with reflux oesophagitis revealed a larger volume of the total and proximal stomach at two and 10 minutes (p=0.05; p=0.01, respectively), and an increased proximal/distal intragastric volume ratio at 10 minutes (p=0.04). Patients also experienced more epigastric fullness than controls (p=0.0006).Conclusions: The present three dimensional ultrasound system showed excellent agreement with true volumes and low interobserver variation. Soon after a liquid meal, patients with reflux oesophagitis have abnormal pooling of the ingested liquid in the proximal stomach.

Comparative effects of oral and intraduodenal glucose on blood pressure, heart rate, and splanchnic blood flow in healthy older subjects

“…Ultrasonography measurements were performed using a Logiq 9 ultrasonography system (GE Healthcare Technologies, Sydney, Australia) with TruScan Architecture (i.e., built-in magnetically sensored 3D), as described previously (12). For 3D positioning and orientation measurement (POM), a transmitter was placed close to the subject, and a snap-on sensor was attached to a 3.5C broad spectrum 2.5-to 4-MHz convex transducer (12,49). As the transmitter produces a spatially varying magnetic field, and ferrous and conductive metals distort the magnetic field, all metal objects were removed from the subject and from the area directly between the POM transmitter and sensor (32).…”

Inhibitory effects and mechanisms of intestinal electrical stimulation on gastric tone, antral contractions, pyloric tone, and gastric emptying in dogs

“…The critical factors that control gastric emptying are gastric tone, antral peristalsis, pyloric resistance, and duodenal feedback control. Dysfunction of any of these factors results in impairment of gastric emptying (13,19,22,24,25,27,36,38,45,47,48). Effective peristaltic antral contractions play a major role in solid gastric emptying (13,27).…”

Ultrasonography of the Stomach

“…www.intechopen.com 3D ultrasound has also been shown to have higher accuracy and less variability than 2D ultrasound of the stomach (Gilja et al, 1997a) and in a study with a fluid-filled barostat bag, has correlated well with true stomach volumes with low inter-observer variation (Tefera et al, 2002).…”

“…In patients with functional dyspepsia, glyceryl trinitrate (an exogenous donor of NO, a key neurotransmitter in mediating the relaxation of the smooth muscle of the stomach), administered sublingually has been shown to improve the accommodation of the proximal stomach, as measured by ultrasound, and reduce the postprandial symptoms associated with this condition (Gilja et al, 1997b). In patients with reflux esophagitis, the area of the fundus has been shown to be significantly greater after a meal when compared to healthy controls, and these patients experienced greater epigastric fullness (Tefera et al, 2001;Tefera et al, 2002).…”