Methods for measurement of gastric motility

Abstract

Szarka LA, Camilleri M. Methods for measurement of gastric motility. Am J Physiol Gastrointest Liver Physiol 296: G461-G475, 2009. First published January 15, 2009 doi:10.1152/ajpgi.90467.2008There is an array of tests available to measure gastric motility. Some tests measure end points, such as gastric emptying, that result from several different functions, whereas other tests are more specific and test only a single parameter, such as contractility. This article reviews the tests most commonly available in practice and research to evaluate in vivo the gastric functions of emptying, accommodation, contractility, and myoelectrical activity. The rationale for testing, the relative strengths and weaknesses of each test, and technical details are summarized. We also briefly indicate the applications and validations of the tests for use in experimental animal studies. contractility; emptying; accommodation; gastroparesis; dyspepsia ASSESSMENT OF THE MOTOR FUNCTIONS (motility) of the stomach is important in studies of gastric physiology and pathophysiology. Although not generally applied in gastroenterological practice, there is increasing use of tests to evaluate gastric function, particularly less invasive tests in clinical settings.There is an array of tests available to measure gastric motility. Some tests measure end points, such as gastric emptying, that result from several different functions, whereas other tests are more specific and test only a single parameter, such as contractility. This article reviews the tests most commonly available in practice and research to evaluate in vivo the gastric functions of emptying, accommodation, contractility, and myoelectrical activity. The rationale for testing, the relative strengths and weaknesses of each test, and technical details are summarized. A brief discussion is also provided for methods that have been used in animals to study motor functions of the stomach in animals. Tests to Evaluate Gastric Emptying of SolidsGastric emptying is a composite end point reflecting a variety of functions including gastric accommodation, the pressure gradient between the proximal and distal stomach, and antropyloroduodenal contractility and coordination. The trituration of solids and emptying of solid and liquid food from the stomach are arguably the most important physiological functions of the stomach. Abnormal gastric emptying, either accelerated at 1 h or delayed at 4 h, is among the factors that contribute to reporting of dyspepsia or the development of postprandial symptoms after meal challenge (35). For all tests of gastric motility and emptying, there are standard precautions (1): 1) Drugs affecting gastric motility (e.g., anticholinergics, narcotics, and prokinetics) are stopped for 48 h prior to the test, and the study is performed in the morning after an overnight fast. 2) Diabetic subjects should have a glucose level Ͻ275 mg/dl. 3) At the time the meal is ingested, Type 1 diabetic patients should receive half of their normal insulin dose. Gastric Emptying Scintigrap...

Novel antidiabetic nutrients identified by in vivo screening for gastric secretion and emptying regulation in rats

“…Numerous methods enable the measurement of one or the other of these stomach functions. However, until recently, no method was able to measure both gastric emptying and secretion simultaneously in small animals; techniques were lethal or invasive, and additionally, they were limited by spatial, temporal, or quantitative resolution, thereby constraining throughput and observatory value (13,39). We recently overcame these limitations and established a CT method enabling the simultaneous quantification of gastric emptying and secretion in vivo (24).…”

“…Gastric emptying and secretion are fast, and together form the integrated functional output of the stomach. Most available techniques cannot assess both simultaneously, and they are also lethal or invasive to the experimental animal (13,24,39). These methodological constraints limit throughput and, thereby, disable systematic screens for compounds targeting gastric function.…”

Gastroparesis in pregnancy: case report and literature review

“…While this has the advantage of avoiding radiation exposure, it requires a skilled operator and there is limited evidence regarding its use in assessing the emptying of solids which is often first affected in patients with gastroparesis. 9 Intraluminal pressure with surface electrical profiles and MRI are not used in current practice.…”

Ultrasonography of the Stomach

“…Currently, the 'gold standard' for assessment of proximal stomach accommodation is the use of a barostat device, a thin, plastic, inflatable balloon attached to an orogastric catheter, which, when positioned correctly and inflated in the proximal stomach, can measure gastric wall relaxation, and from this the tone of the muscle can be inferred (Azpiroz & Malagelada, 1987). Unlike ultrasonographic assessment, the barostat technique only measures the volume of a sealed balloon, therefore it offers no information about the size or true muscle tone of the stomach (Szarka & Camilleri, 2009). The barostat device can be uncomfortable, is highly invasive and has been shown to influence gastric motor patterns (Moragas et al, 1993;Parys et al, 1993).…”