ANTRODUODENAL MANOMETRY - 24-HOUR AMBULATORY MONITORING VERSUS SHORT-TERM STATIONARY MANOMETRY IN PATIENTS WITH FUNCTIONAL DYSPEPSIA

Objectives: To examine the interdigestive and postprandial antroduoden al motility patterns of patients with functional dyspepsia using prolo nged ambulatory antroduodenal manometry and to compare these findings with conventional stationary manometry. Methods: Prolonged ambulatory and short-term stationary antroduodenal manometry were performed in 10 patients with functional dyspepsia and in 10 healthy volunteers (cont rols). Results: During stationary manometry only a few interdigestive motor complex (MMC) cycles were recorded. Using the ambulatory techniq ue, fewer MMC cycles were observed in patients than in controls (2.2+/ -0.63 and 4.1+/-0.54, respectively; P=0.030). During phase II of the M MC, both techniques showed a higher antral motility index in patients (P=0.017 and P=0.049 for stationary and ambulatory manometry, respecti vely). The postprandial antral motility index was similar for patients and controls using stationary manometry. With the ambulatory techniqu e, the antral motility index 1-1.5 h after breakfast was lower in pati ents than in controls (P=0.020). Both techniques showed that the patie nts had a higher duodenal motility index after dinner and after breakf ast (P<0.05). Both techniques revealed more burst activity in patients than in controls (stationary: 10.7 versus 1.8% of the time; ambulator y: 1.7 versus 0.2% of the time; P=0.004 and P=0.051, respectively). Us ing a 10-min window period before the onset of symptoms, seven symptom episodes (33.3%) were found to be related to burst activity and retro grade or non-propagated phase III activity. Conclusions: Ambulatory ma nometry is superior to stationary manometry for evaluating patients wi th functional dyspepsia, because patients can be studied for a prolong ed period (allowing adequate evaluation of interdigestive abnormalitie s) and under physiological conditions. Prolonged monitoring also allow s assessment of the relationship between symptoms and motor abnormalit ies.