bluuebunny/crossref_metadata_2025_split huggingface dataset:
20 Electrogastrography is of limited value in the diagnosis of motility disorders
Authors: ABID S , LINDBERG G 
Published: May 2006

Background:  Electrogastrography (EGG) is a technique for recording gastric myoelectric activity. Conflicting results were obtained in previous studies when EGG was applied in motility disorders of the stomach associated with various systemic diseases.Aim:  To investigate whether the underlying diagnosis could be predicted from EGG parameters.Material and methods:  This is a retrospective analysis of patients with motility disorders who underwent EGG as part of their clinical work‐up. A single bipolar channel measured the EGG. The ability of EGG to identify diagnostic groups was tested by comparing 21 EGG parameters for each diagnostic group or symptom against all other patients in the sample.Results:  A total of 151 patients, 125 (83%) females, and mean age 45 ± 14 years were analysed. There were 52 patients with irritable bowel syndrome (IBS), 22 with enteric dysmotility, 26 with slow transit constipation (STC), 11 with chronic intestinal pseudo‐obstruction (CIP), 13 with gastroparesis or functional dyspepsia, three post‐surgical, and 24 patients with other diagnoses. In general, the discriminatory power of EGG for underlying motility disorder was low. Only those with STC showed a reasonable number of differences in EGG parameters compared to all other groups (Table). Patients with IBS had lower fasting and postprandial variability of the dominant frequency (DF) and a higher percentage of postprandial time with normogastric DF.Conclusion:  The ability of EGG to identify motility disorders as well as symptoms in general was poor. EGG findings in patients with STC require validation.

Significant EGG variables in slow transit constipation (STC)

EGG parameter
STC (n = 26)
Other diagnosis (125)

Postprandial normal power (Log)
3.7 ± 0.4
4.0 ± 0.5

Postprandial tachygastria power (Log)
3.5 ± 0.4
3.7 ± 0.4

Postprandial bradygastria% median and range
2 (0–20)
0 (0–17)

Postprandial normal% median and range
87 (56–100)
96 (0–100)

Postprandial tachygastria% median and range
9 (0–33)
3 (0–100)

Postprandial DFIC% median and range
26 (8–72)
18 (2–77)

Postprandial period dominant power PDP (Log)
2.1 ± 0.6
2.4 ± 0.5

Power Ratio (Log)
0.2 ± 0.5
0.4 ± 0.5
29 Burn‐induced GI dysmotility in severe burn injury
Authors: SALLAM H , OLIVEIRA H , CHEN JDZ 
Published: May 2006

Introduction:  Severe burn injury is known to delay gastric emptying in both animals and humans; however no data are available on its effect on gastric myoelectrical activity (GMA). We aimed at studying the effect of burn injury on GMA as it might contribute to burn‐induced delayed gastric emptying.Methods:  Surgical implantation of a pair of cardiac pacemaker wires onto the stomach serosa was carried out in 20 adult male Sprague‐Dawley rats. Following recovery, GMA was recorded for 30 min in both fasting and fed conditions. The following day, rats received a sham or a 3rd degree scald burn injury under anesthesia. Proper fluid resuscitation and analgesia were given to all animals. Six hours after sham/burn injury, GMA was recorded for 30 min again in both fasting and fed conditions. A methylcellulose meal was mixed with phenol red (marker), so that the percentage of gastric emptying could be calculated based on the amount of phenol red recovered from the stomach. GMA parameters were computed using previously validated spectral analysis software developed in our laboratory, including dominant frequency/power and percentages of normal slow waves, bradygastria, tachygastria and arrhythmia. The normal slow wave frequency range was 4–6 cycles per min (cpm) in rats, while ≤4 cpm and ≥6 cpm were considered bradygastria and tachygastria respectively. Arrhythmia was established if the slow wave frequency had no specific range.Results:  1) None of GMA parameters showed any statistical differences in the fasting condition after burn (p > 0.05). 2) Significant changes in GMA with burn were only observed postprandially, including: a decrease in dominant frequency (4.5 ± 0.2 vs. 5.1 ± 0.2, p = 0.002) and in the percentage of normal slow waves (67.2 ± 7.3 vs. 84.5 ± 4.1, p = 0.02) and an increase in the percentage of bradygastria (24.7 ± 6.8 vs. 9 ± 3.9, p = 0.02). 3) The percentage of gastric emptying was decreased after burn to 40.3 ± 6.5 vs. 77 ± 3.2 in previously obtained controls (p = 0.0003); however, it did not correlate significantly to any of GMA parameters before or after burn, whether in fasting or in fed conditions (p > 0.05).Conclusion:  Severe burn injury impairs both GMA and gastric emptying in rats. However, these alterations are not correlated with each other, suggesting that gastric dysrhythmia is a manifestation of burn rather than the cause of burn‐induced delayed gastric emptying.
31 Effects of test meal on multi‐channel Electrogastrography and autonomic nervous system function in different subtypes of patients with functional dyspepsia
Authors: XU X , SONG Z , DING Z , WANG Z , CHEN X , KE M 
Published: May 2006

Previous studies have shown that patients with functional dyspepsia (FD) had significantly lower percentage of slow wave coupling (%SWC) in fasting state. The aim of this study was to utilize MEGG and ANS test to investigate the difference of MEGG parameters and ANS parameters between different subtypes of FD patients and healthy subjects (HS).Methods:  Sixty‐two patients with the diagnosis of FD were enrolled in this study (16 M, 46 F, mean age: 43 years) and divided into dysmotility‐like FD group (15 M, 35 F, mean age: 42 years) and ulcer‐like FD group (1 M, 11 F, mean age: 46 years) based on Rome II criteria. 50 HS were recruited as control (25 M, 25 F, mean age: 44 years). MEGG were recorded simultaneously with the electrocardiogram (ECG) recording for 30 min in the fasting state and 60 min after a standard 450 Kcal test meal. MEGG parameters included dominant frequency (DF), normal percentage of 2–4 cpm gastric slow waves (%N) and %SWC. ANS parameters included sympathovagal balance LF/HF Ratio, mainly sympathetic activity LF and vagal activity HF. Results:  (1) Compared with HS, %SWC was significantly lower in ulcer‐like FD group in fasting state (P < 0.05) but not in fed state. No significant difference of %SWC was shown between dysmotility‐like FD group and HS either in fasting state or in fed state. There was no significant difference between the two FD groups and HS in DF and %N neither in fasting state nor in fed state. (2) Compared with HS, LF/HF ratio and LF were significantly lower and HF was significantly higher in fasting state in dysmotility‐like FD group (P < 0.05), this difference was abolished by test meal in the 1st 30 min fed state and the lower LF and higher HF were present in the 2nd 30 min fed state again in dysmotility‐like FD group. There was no significant difference between ulcer‐like FD group and HS in any of those ANS parameters either in fasting state or in fed state.Conclusions:  Gastric slow wave coupling was abnormal in patients with ulcer‐like FD. Patients with dysmotility‐like FD had abnormal ANS function in fasting state and test meal could only correct the abnormal ANS for short time, which suggest that different subtypes of FD may have different patterns in ANS test.
32 How common is rapid gastric emptying in gastroparesis? Comparison of area under the curve, total gastric emptying and 1‐hour values in patients and normal volunteers
Authors: ABELL TL , STARKEBAUM W , ABIDI N 
Published: May 2006

Introduction:  Rapid gastric emptying has been described not only in patients with nausea and vomiting and gastroparesis but also in obesity and dyspepsia. We investigated the use of three measures of rapid gastric emptying in a large group of patients with gastroparesis as compared to normal controls.Patients:  From a pool of 214 consecutive patients with the symptoms of gastroparesis we reviewed the results of standardized solid gastric emptying tests and compared the results to a group of normal controls as previously described (AJG 95: 1456‐14622000). Patients were 39 males, 175 females mean age 42 years, with diagnosis of 42 Diabetes Mellitus, 26 Post Surgical and 146 Idiopathic diseases.Methods:  Gastric emptying was compared by three models: Area under the emptying curve (AUC, rapid < 0.257), total gastric emptying (TGE: the sum of 1, 2 and 4 hours; rapid < 47), and percentage remaining at 1 hour (<37%) for rapid and/or at 4 hours (>10%) for delayed emptying, using data and techniques previously described (AGJ2004; 99: S45 and NGM 2005; 17: 470).Results:  Measurable gastric emptying could be determined for 4 hours emptying in 146 patients; 87 patients had complete 1, 2 and 4 hours emptying. 44 patients had delayed emptying by 4 hour% >10%, seven patients (8%) had rapid gastric emptying by AUC and eight pts (9%) had rapid emptying by the TGE values; and 16 (18%) pts had rapid emptying by the 1 hour value alone.Conclusion:  Rapid gastric emptying of a solid meal is not uncommon in patients with the symptoms of gastroparesis. The AUC and TGE models identified approximately the same number of patients with rapid emptying, while the 1‐hour model identified approximately twice as many patients. Using the three techniques described to determine rapid gastric emptying awaits prospective use in other patients, including dyspepsia and obesity. Standardized measure for rapid gastric emptying may be useful in evaluating therapeutic outcomes for these disorders.
37 Autonomic nervous system response to a solid meal in healthy children: its relation to gastric myoelectrical activity
Authors: LIN Z , FRIESEN CA , SCHURMAN JV , ANDRE L , ZHO B , MCCALLUM RW 
Published: May 2006

Electrogastrogram (EGG) is a measurement of gastric electrical activity using cutaneous electrodes. Autonomic nervous function is an important modulator of gastric activity, but little is known regarding its relation with the EGG parameters. The aims of this study were to investigate the patterns of myoelectrical and autonomic activities both in the fasting and in the fed state and their correlation in healthy children.Methods:  Simultaneous recordings of EGG and electrocardiogram were performed in 28 healthy children (13 M, 15 F, mean age: 12.4 years, range: 8–17) for 30 min in the fasting state and 60 min after a solid test meal. Spectral analysis was performed to compute EGG parameters and their postprandial changes. The autonomic activity was assessed based on spectral analysis of the heart rate variability (HRV) signal which was derived from the electrocardiogram. Data are presented as mean ± SE.Results:  The solid meal resulted in a postprandial increase in the EGG dominant frequency (2.92 ± 0.08 cpm vs. 3.16 ± 0.07 cpm, P < 0.05), dominant power (46.9 ± 0.8 dB vs. 53.7 ± 1.5 dB, P < 0.05), and percentage of normal slow waves (81.9 ± 2.0% vs. 89.0 ± 2.0%, P < 0.05). Spectral analysis of HRV revealed that sympathetic activity primarily associated with power in the low‐frequency band of HRV (LF) was increased in the postprandial state (0.34 ± 0.02 vs. 0.43 ± 0.03, P < 0.05). The parasympathetic activity primarily associated with power in high‐frequency band of HRV (HF) was significantly higher in the fasting state (0.66 ± 0.02 vs. 0.58 ± 0.03, P < 0.05). The sympathovagal balance associated with the LF‐to‐HF ratio was much higher in the postprandial state (0.56 ± 0.05 vs. 0.90 ± 0.13, P < 0.05). Moreover postprandial LF was positively and HF was negatively correlated with the postprandial increase in EGG dominant power (r = 0.39; P = 0.04, respectively).Conclusions:  The solid meal resulted in a significant increase in EGG dominant frequency, dominant power and percentage of normal slow waves as well as sympathovagal balance in healthy children, suggesting that both vagal and sympathetic pathways are involved in modulation of gastric myoelectrical activity.
40 Gastric electrical stimulation for adolescents with intractable nausea and gastroparesis
Authors: ISLAM S , GOSCHE JR , ABELL TL 
Published: May 2006

Purpose:  Gastric electrical stimulation (GES) has been performed in adults as a treatment for refractory nausea and vomiting, in patients who have failed medical treatment. It has not been systematically applied to individuals less than 18 years old with this problem.Methods:  Six patients, one male, five female with chronic nausea and vomiting with a mean age of 15 years (range 13–18), were evaluated with gastric emptying studies and cutaneous electrogastrograms (EGG) for temporary GES. All patients had idiopathic gastroparesis. Five patients subsequently underwent placement of a permanent GES device ‐ four were done laparoscopically and one was open. Each patient had an intra operative EGG and in three patients, seromuscular biopsies from the stomach or jejunum were obtained as well. Symptoms were recorded at baseline, after temporary pacing and then after permanent pacing using a Likert scale (0–4 for each symptom with a total of 5 symptoms). Statistical analysis was performed using a paired student's t test and a value of <0.05 was considered significant.Results:  At baseline, all patients were symptomatic and most had delayed solid gastric emptying and abnormal EGG. As a group, there was a significant improvement in nausea (3.4 ± 0.4–1.7 ± 0.3, p = 0.005), and combined symptoms score (11.3 ± 2.0–5.0 ± 1.5, p = 0.02). Gastric emptying and EGG values also improved. Biopsy was abnormal in 2 of 3 patients, showing diminished and abnormal Cajal cells in the two patients who had less improvement long term. Follow up ranged from 1–20 month, with an average of 9 month.Conclusions:  GES can be successfully applied to adolescents with intractable nausea and gastroparesis symptoms. The role of the cells of Cajal in enteric motility needs investigation. Long term efficacy of this therapy in children needs to be established.
41 Temporary gastric electrical stimulation and the EGG: the SENSA phenomenon.
Authors: ABELL TL , MINOCHA A , ABIDI N 
Published: May 2006

Introduction:  We previously reported that temporary gastric electrical stimulation (GES) is associated with an increase in EGG frequency (IEGGS 2005). We now report further on this phenomenon, which we have labeled Submucosal Enteric Nervous System Activation or SENSA.Patients:  We studied 121 patients (18 m, 103 f, mean age 39 years with dx: 71 Idiopathic, 37 diabetes mellitus and 13 post‐surgical disorders) who underwent temporary endoscopic GES. All patients had complete data for baseline cutaneous EGG (Base) and a repeat cutaneous EGG (Temp) after 3 day of temporary GES.Methods:  Patients had cutaneous EGGs at baseline and again after temporary GES, performed with high‐frequency, low‐energy stimulation parameters, as previously described (GIE, 2005). Temporary GES mucosal electrode placement was near the submucosal plexus, confirmed by endoscopy. EGGs, performed at a standard time in relation to a low‐fat meal, were reported as average frequency (F, in cpm), were compared by t‐tests with baseline, reported as mean ± SE.Results:  For the whole group EGG done with Temporary GES revealed a slight increase in frequency over baseline, but the results were not statistically significant. However, when stratified at baseline as Low (average F < 3.3) or High (≥3.3) a number of differences were present: the patients with Low EEG increased significantly (2.7 (0.1) at Base to 4.5 (0.2) with Temp , p = 0.001) but not for high EGG (4.7 (0.1) to 4.4 (0.1), p = 0.67). See the results detailed in the table below.Conclusion:  The occurrence of the phenomena of Submucosal Enteric Nervous System Activation (SENSA) appears dependent on the characteristics of the baseline EGG. As with gastric emptying, careful characterization of baseline values is important when reporting the effects of GES on the EGG. The SENSA phenomena, when occurring, may give important clues to the mechanisms involved in the beneficial effects of temporary gastric electrical stimulation.

Group
All
Low
DM Low
ID Low
PS Low
High
DM High
ID High
PS High

Base
4.3 (0.1)
2.8 (0.1)
2.8 (0.1)
2.8 (0.1)
2.1 (0.7)
4.7 (0.1)
4.4 (0.2)
4.8 (0.2)
4.7 (0.3)

Temp
4.4 (0.1)
4.5 (0.2)
3.8 (0.3)
5.3 (0.6)
6.0 (0.1)
4.3 (0.1)
4.4 (0.4)
4.9 (0.3)
4.9 (1.7)

p value
>0.05
0.001
<0.05
<0.05
<0.05
0.67
>0.05
>0.05
>0.05
43 Gastric Electrical Stimulation in Severe Gastroparesis – The Scottish Experience
Authors: GRAY J , FULLARTON GM 
Published: May 2006

Introduction:  Gastroparesis (GP) is a common complication of type 1 and 2 diabetes affecting up to 50% of the diabetic population. In severe cases diabetic gastroparesis (DGP) may be profoundly disabling with severe GI symptoms, prolonged hospital stay and potentially life‐threatening metabolic upset. Standard management of DGP with dietary changes or drug treatment is unsatisfactory in many patients. The development of gastric electrical stimulation (GES) in drug refractory DGP has been shown to be beneficial in this difficult group of patients. In Scotland GES has only recently been available as a treatment option and we report here our initial experience in both diabetic and idiopathic gastroparesis patients. We have treated 7 patients (5 female), age 30 (21–73) (median, range) over a 3 years period. Of the 7 patients 5 were type 1 diabetics and 2 had idiopathic gastroparesis. All had severe drug refractory GP and 6/7 had required enteral feeding prior to GES implantation. All 7 patients had GES initiated with the Enterra (Medtronic) neural stimulator placed at mini‐laparotomy. No peri‐operative complications were noted. One patient died of unrelated sepsis 6 month post‐implant. GES was initiated with standard parameters (frequency 14 Hz, intensity 5 mA, pulse width 330 μs; cycle on 0.1 s; cycle off 5 s).All 6 patients who had required enteral feeding pre‐GES had their feeding tubes removed at surgery and have had normal nutritional intake without supplemental feeding after GES [follow‐up 24 month (11–34)].Gastric emptying as assessed by dual phase solid/liquid labeled meals improved in 50% of our patients.Conclusions:  GES significantly improves the weekly vomiting frequency in patients with GP and avoids the need for enteral feeding. Long‐term GES should be considered as a treatment option in all drug refractory GP patients.

Results (6 months)
PRE
POST
GES

Median (range)

Weekly vomiting frequency
25 (15–35)
4 (1–6)
*p < 0.001

Weight (kg)
49 (44–70)
54 (50–89)
p = ns
6 Effect of a water load test on gastric myoelectrical activity and upper gastrointestinal symptoms in patients with nausea and vomiting of pregnancy
Authors: KOCH KL , GOODWIN TM , ROMERO RJ , LEVINE ME , TISON H 
Published: May 2006

Nausea and vomiting of pregnancy (NVP) is a common syndrome in which symptoms predominate in the first trimester of pregnancy. Symptoms range from mild to severe and afflict up to 80% of pregnant women. The underlying mechanisms of NVP remain poorly understood. Provocative gastric function testing has not been performed in these patients.Aims:  The aim of this study were to determine the effects of the water load test (WLT) on gastric myoelectrical activity, nausea, and other upper gastrointestinal symptoms in pregnant women.Method:  46 women with NVP were studied prospectively. Gastric myoelectrical activity was recorded throughout the study by electrogastrography (EGG). A 15 min baseline period was followed by a WLT during which patients ingested water until full over a 5 min period. After the WLT, an additional 30 min of EGG was recorded. EGG responses were categorized into four groups: normal (2.5–3.7 cpm), bradygastria (1.0–2.5 cpm), tachygastria (3.7–10.0 cpm), and mixed gastric dysrhythmia (tachygastria and bradygastria). Nausea, bloating, stomach fullness, and abdominal discomfort were recorded before, and 10, 20, and 30 minutes after the WLT on 100 mm visual analogue scales.Results:  In response to the WLT, 14% of the women exhibited normal EGG responses, while significantly more (86%) exhibited gastric dysrhythmias (p < 0.01). Of the dysrhythmic EGG responses, 57% were tachygastria, 11% were bradygastria, and 18% were mixed gastric dysrhythmia. Patients with tachygastria ingested less water (338 ml) than patients with normal (371 ml), bradygastria (415 ml), or mixed gastric dysrhythmia (394 ml) patterns, but the differences were not statistically significant. 46% of the women reported nausea at baseline; significantly more women (72%) reported nausea after the WLT (p < 0.05). At 20 min after the WLT, a significant, direct relationship was observed between nausea severity and tachygastria (p < 0.05). The other upper gastrointestinal symptoms were not significantly increased by the WLT. Conclusions:  (1) 86% of the pregnant women in this sample developed gastric dysrhythmias in response to the WLT. (2) Tachygastria was the most common dysrhythmia, and increased tachygastria was correlated with increased nausea. Gastric dysrhythmias are evoked by the WLT in women with NVP, suggesting these dysrhythmias have a pathophysiological role in the mechanism of NVP, and are a target for future therapies.
7 Characteristics of the electrogastrogram in patients with cyclic vomiting syndrome
Authors: NAMIN F , LIN Z , FORAN P , MCCALLUM RW 
Published: May 2006

Cyclic vomiting syndrome (CVS) is an unexplained disorder characterized by recurrent attacks of nausea and vomiting. The aim of this study was to investigate the characteristics of gastric myoelectrical activity in patients meeting Rome II criteria for CVS and studied between cycles using cutaneous electrogastrography (EGG).Methods:  11 patients (6M, 5F, mean age: 31 years, range: 16–60) with CVS (5 symptomatic and 6 asymptomatic at the time of the study) underwent EGG between acute CVS attacks. EGG recordings were made for 30 minutes in the fasting state and for 60 minutes after ingestion of a caloric liquid meal (Boost, 360 kcal). Power spectral analysis methods were used to extract quantitative EGG parameters: EGG dominant frequency/power, change in postprandial EGG power, percentages of normal slow waves (2 to 4 cpm) and dysrythmias including tachygastria (slow‐wave frequency >4 cpm) and bradygastria (slow‐wave frequency <2 cpm) in each recording session. Patients were asked to score their symptoms of nausea, vomiting and abdominal pain (0 = none, 4 = constant) during both pre‐ and postprandial periods. Data are expressed as mean ± SE.Results:  7/11 demonstrated an abnormal EGG (dysrhythmia >30% in 4 patients and a decrease in postprandial EGG power in 6 patients). 5/11 patients had symptoms (nausea) during EGG recording and all had an abnormal EGG. The major abnormalities of EGG were tachygastria and a decrease in EGG postprandial power change. In comparison with asymptomatic patients at the time of the study, symptomatic patients had significantly more tachgastria (20.4 ± 3.9% vs. 6.7 ± 2.7%, P = 0.01) and significantly less normal slow waves (67.6 ± 2.0% vs. 86.7 ± 2.8%, P < 0.05) in the fed state. The increase in EGG postptandial power in symptomatic patients was also significantly less than asymptomatic patients (­2.55 ± 1.01 dB vs. 1.14 ± 0.54 dB, P < 0.05).Conclusions:  1) Abnormalities of EGG are presented in CVS between acute episodes and could explain some of the symptoms present; 2) Abnormal gastric myoelectrical activity is part of the spectrum of the CVS patients.