EVALUATION OF GASTRIC ANTRAL MOTOR-PERFORMANCE IN PATIENTS WITH DYSMOTILITY-LIKE DYSPEPSIA USING REAL-TIME HIGH-RESOLUTION ULTRASOUND

Although manometric antral hypomotility and delayed gastric emptying h ave been reported separately in patients with dyspepsia, relationships between symptoms, antral contractility and emptying rate have not bee n sought. The present study therefore aimed to evaluate, simultaneousl y, gastric antral excursion characteristics and emptying in a sub-grou p of patients with severe functional dyspepsia using high-resolution r eal-time ultrasound. The circumference of the relaxed and contracted a ntrum was measured at 15-min intervals after ingestion of a 360 mt mix ed nutrient meal in 36 chronic dyspepsia patients with symptoms of pos t-prandial bloating and epigastric distension, and in 25 healthy volun teers. Antral emptying (measured as the rate of decrease in circumfere nce of the relaxed antrum) was slower in patients than normals (P = 0. 02). In both groups, the average values for antral excursion were simi lar but the range of excursion in patients was significantly wider tha n in controls (F < 0.001), with 11 patients showing values above, and 8 showing values below the normal range. There was no relationship bet ween antral emptying and antral excursion in either patients or volunt eers. In conclusion, patients with severe functional dyspepsia show a wide range of antral performance characteristics, suggesting not only that the mechanisms responsible for the control of antral motor functi on are disturbed but also that the cause of the symptoms and the distu rbed antral motor function are probably not directly related.