Koch KL, Van Natta ML, Parkman HP, et al. Subtypes of gastroparesis and functional dyspepsia based on gastric myoelectrical activity in response to the water load satiety test. Abstracts of the 19th ANMS Annual Meeting, August 13–15, 2021 Boston, USA.P.35

Авторы: Koch K.L. / Van Natta M.L. / Parkman H.P. / McCallum R.W.  / Kuo B. / Sarosiek I.  / Abell T.L.  / Grover M. / Farrugia G. / Shulman R.J.  / Tonascia J.A.  / Hamilton F.A. / Pasricha P.J.

Subtypes of gastroparesis (GP) and functional dyspepsia (FD) based on gastric myoelectrical activity (GMA) in response to the water load satiety test (WLST)

Перевод на русский язык

K.L. Koch¹, M.L. Van Natta², H.P. Parkman³, R.W. McCallum⁴, B. Kuo⁵, I. Sarosiek⁴, T.L. Abell⁵, M. Grover⁶, G. Farrugia⁷, R. Shulman⁸, J. Tonascia², F. Hamilton⁹, P.J. Pasricha¹

For the NIH/NIDDK Gastroparesis Clinical Research Consortium.

¹ Wake Forest School of Medicine;
² Johns Hopkins University, Baltimore, MD;
³ Temple University, Philadelphia, PA;
⁴ Texas Tech University Health Sciences Center, El Paso, TX;
⁵ Massachusetts General Hospital, Boston, MA;
⁶ University of Louisville, Louisville, KY;
⁷ Mayo Clinic, Rochester, MN;
⁸ Baylor College of Medicine, Houston, TX;
⁹ NIDDK, Bethesda, MD.


Introduction: Symptoms associated with FD and GP are similar and are often unrelated to the rate of gastric emptying. On the other hand, patients with FD and GP have gastric dysrhythmias and loss of normal 3 cpm GMA.

Aims: To compare GMA and symptoms in patients with GP and FD in response the WLST.

Methods: Patients with symptoms associated with GP were studied. GP was defined by > 60% meal retained at 2 hrs. and/or > 10% at 4 hrs. by scintigraphy. GMA was recorded with cutaneous electrogastrography with the WLST during which patients ingested water until completely full over a 5-minute period. The % GMA activity in 4 frequency ranges (normal 2.5–3.7 cpm; bradygastria, 1.0–2.5 cpm; tachygastria, 3.7–10.0 cpm; duodenal-respiration, 10–15 cpm) was determined and compared with controls. Symptoms were assessed using a 100 mm visual analog scale. Ingestion of less than 238 ml of water in 5 min was considered abnormal.

Results: 284 patients with GP and 113 patients with FD (symptoms associated with GP but normal emptying) were studied. GP and FD patients ingested similar volumes of water (mean ± SD: 378 ± 218 ml and 402 ± 226 ml; p = 0.15) and reported similar increases in postprandial fullness, nausea, bloating, and abdominal discomfort. 26% of GP and 19% of FD patients ingested < 238 ml water (p = 0.05). Gastric dysrhythmias were recorded in 66% and 65% of patients with GP and FD, respectively; normal 3 cpm GMA was recorded in 34% and 35% of patients with GP and FD, respectively. Although overall % of gastric dysrhythmias and normal GMA were similar in the two groups, there were differences in the classifications of specific diagnoses (p = 0.02) (Table 1).

Conclusions: 1. Nearly 2/3 of the patients with GP and FD have dysrhythmic GMA and 1/3 have normal 3 cpm GMA, identifying subtypes of GP and FD based on GMA; 2. Patients with GP and FD also had similarities in water volume ingested and symptoms induced and 3. These findings suggest overlapping pathophysiological characteristics in patients with GP and FD which link the disorders on the spectrum of gastric neuromuscular disorders.

Table 1 GMA Responses in GP and FD

	Gastroparesis (n = 284)	Functional dyspepsia (n = 113)
Dysrhythmic GMA response
Tachygastria	87 (31%)	35 (31%)
Bradygastria	50 (18%)	23 (20%)
Mixed dysrhythmia	25 (9%)	1 (1%)
Hyponormal 3 cpm GMA	26 (9%)	14 (13%)
Normal 3 cpm GMA response
Normal 3 cpm GMA	44 (15%)	21 (19%)
Hypernormal 3 cpm GMA	14 (6%)	10 (9%)
Normal 3 cpm with dysrhythmia	38 (13%)	9 (8%)

p = 0.02 (Fisher’s exact test)

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Koch KL, Van Natta ML, Parkman HP, McCallum RW, Kuo B, Sarosiek I, Abell TL, Grover M, Farrugia G, Shulman R, Tonascia J, Hamilton F, Pasricha PJ. Subtypes of gastroparesis and functional dyspepsia based on gastric myoelectrical activity in response to the water load satiety test. Abstracts of the 19th American Neurogastroenterology and Motility Society Annual Scientific Meeting, August 13–15, 2021, Boston, Massachusetts, USA. № 72.

Neurogastroenterology & Motility. 2021;33(Suppl. 1):e14230. P. 35. wileyonlinelibrary.com/journal/nmo

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