Role of electrogastrography and gastric impedance measurements in evaluation of gastric emptying and motility

Smout, A. J. P. M.; Jebbink, H. J. A.; Akkermans, L.M.A.; Bruijs, P. P. M.

doi:10.1007/bf02300387

Cited by 36 publications

(14 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, some clinicians, utilizing electrogastrography (EGG) to evaluate symptoms of dyspepsia, gastroparesis or other motility disorders, attempt to determine whether slow wave frequency conforms to accepted ‘normal’ limits of 2–4 cpm (Koch, 2001; Lin & Chen, 2001; Leung et al 2006; Sha et al 2009). However, the correlation between symptoms and slow wave frequency, as assessed by EGG, is not strong (Jebbink et al 1994; Smout et al 1994; Chen et al 1996; Parkman et al 1997), and reasons for this need to be clarified.…”

Section: Introductionmentioning

confidence: 98%

Analysis of pacemaker activity in the human stomach

Rhee

Lee

Son

et al. 2011

The Journal of Physiology

View full text Add to dashboard Cite

Non-technical summaryWhat is known about gastric electrophysiology and used in motility clinics throughout the world is mostly deduced from animal studies and extracellular recordings from human patients. Extracellular recording from gastrointestinal muscles, however, is prone to extensive motion artifact, and it is not clear that animal models can be translated directly to human physiology. Therefore, we have performed a detailed analysis of electrical activity from carefully mapped specimens of gastric muscle removed from humans during surgery for gastric cancers. Our data show several important differences in electrical activity recorded with intracellular microelectrodes and accepted gastric electrophysiological dogma. We observed ongoing electrical slow wave activity in the gastric fundus; we also found no evidence for a slow wave frequency gradient. Muscles from all regions through the thickness of the muscularis demonstrated intrinsic pacemaker activity, and this corresponded with the widespread distribution of pacemaker cells.Abstract Extracellular electrical recording and studies using animal models have helped establish important concepts of human gastric physiology. Accepted standards include electrical quiescence in the fundus, 3 cycles per minute (cpm) pacemaker activity in corpus and antrum, and a proximal-to-distal slow wave frequency gradient. We investigated slow wave pacemaker activity, contractions and distribution of interstitial cells of Cajal (ICC) in human gastric muscles. Muscles were obtained from patients undergoing gastric resection for cancer, and the anatomical locations of each specimen were mapped by the operating surgeon to 16 standardized regions of the stomach. Electrical slow waves were recorded with intracellular microelectrodes and contractions were recorded by isometric force techniques. Slow waves were routinely recorded from gastric fundus muscles. These events had similar waveforms as slow waves in more distal regions and were coupled to phasic contractions. Gastric slow wave frequency was significantly greater than 3 cpm in all regions of the stomach. Antral slow wave frequency often exceeded the highest frequency of pacemaker activity in the corpus. Chronotropic mechanisms such as muscarinic and prostaglandin receptor binding, stretch, extracelluar Ca 2+ and temperature were unable to explain the observed slow wave frequency that exceeded accepted normal levels. Muscles from all regions through the thickness of the muscularis demonstrated intrinsic pacemaker activity, and this corresponded with the widespread distribution in ICC we mapped throughout the tunica muscularis. Our findings suggest that extracellular electrical recording has underestimated human slow wave frequency and mechanisms of human gastric function may differ from standard laboratory animal models.

show abstract

Section: Introductionmentioning

confidence: 98%

Analysis of pacemaker activity in the human stomach

Rhee

Lee

Son

et al. 2011

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…At the time being, however, the sonographic techniques as well as more sophisticated techniques such as electrical impedance epigastrography (35), electrical impedance tomography (36,37), high speed impedance tomography (38), magnetic resonance imaging (39) and echoplanar magnetic resonance imaging (40) may be useful in the research setting but cannot be recommended as tools to record gastric emptying in clinical practice.…”

mentioning

confidence: 99%

Epigastric Fullness

Stacher

1999

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

Epigastric fullness may be caused by a disordered gastric motor function, resulting in delayed gastric emptying, but may also be caused by rapid emptying, leading to a distention of the proximal small intestine. A rational diagnostic approach to a patient complaining of epigastric fullness is needed to reveal the underlying disorder or disease and to enable an adequate, targeted therapy. The clinical impression based on symptoms is unreliable and cannot distinguish function disorders and benign disease from severe conditions.

show abstract

“…It has been suggested that these waves could be reflections of gastric contractions, 5 but simultaneous antroduodenal manometry failed to show an association between IGG and antral contractile activity in the fasting state. 21 A simultaneous relation between the IGG and the electrical activity from the stomach measured with electrogastrography (EGG) 2 was, however, supporting the assumption that the waves were of gastric origin. A small variation in the intrinsic frequency of the gastric pacemaker with a temporarily decreased postprandial frequency followed by an increase have been shown employing both IGG and EGG.…”

Section: Discussionmentioning

confidence: 97%

Gastric emptying patterns of a liquid meal in newborn infants measured by epigastric impedance

Lange

Funch‐Jensen

Thommesen

et al. 1997

Neurogastroenterology Motil

View full text Add to dashboard Cite

Epigastric impedance was used to measure the gastric emptying patterns of a liquid non‐caloric meal (5 mL water kg−1) in 30 healthy newborn infants. Twenty‐six mature infants were examined in the first eight days of life, and four preterm infants were examined within 6 weeks after birth. The recordings consisted of two components: the emptying signal (the DC component), and a phasic 3 cycles per minutes (CPM) signal (the AC component). In some of the infants the phasic 3 CPM signal was also seen during the fasting state. For mature infants the median half emptying time (T50) was 6.9 min. For a second meal given within one hour after the first meal the half emptying time was 5.5 min (P < 0.01). In preterm infants the emptying times were not significantly different from mature infants. Day‐to‐day variation was low with a coefficient of variation of 17% in nine infants. A periodic change of the impedance signal, the phasic 3 CPM signal, was observed after a meal in 24 of the infants. The median frequency was 3.0 CPM in 20 mature and 2.9 CPM in four preterm infants. In nine infants a phasic 3 CPM signal was also observed during the fasting state, with a median frequency of 2.9 CPM. Measurement of gastric emptying pattern with epigastric impedance is a simple investigation for the evaluation of gastric emptying time and phasic activity in mature and preterm infants. However, the method is sensitive to spontaneous movements of the children, resulting in non‐valid measurements in around one fourth of the infants.

show abstract

Role of electrogastrography and gastric impedance measurements in evaluation of gastric emptying and motility

Cited by 36 publications

References 5 publications

Analysis of pacemaker activity in the human stomach

Analysis of pacemaker activity in the human stomach

Epigastric Fullness

Gastric emptying patterns of a liquid meal in newborn infants measured by epigastric impedance

Contact Info

Product

Resources

About