Rj. Brzana et al., GASTRIC MYOELECTRICAL ACTIVITY IN PATIENTS WITH GASTRIC OUTLET OBSTRUCTION AND IDIOPATHIC GASTROPARESIS, The American journal of gastroenterology, 93(10), 1998, pp. 1803-1809
Objective: The cause of gastroparesis may be uncertain in some patient
s. Mechanical obstruction of the stomach or duodenum should be exclude
d in patients with idiopathic gastroparesis, The objective of this stu
dy was to compare gastric myoelectrical activity in patients with idio
pathic gastroparesis with that of patients with gastroparesis due to m
echanical obstruction of the stomach or duodenum, Methods: Electrogast
rography techniques were used to record gastric myoelectrical activity
in 20 patients with idiopathic gastroparesis and in nine patients wit
h gastroparesis secondary to gastric outlet obstruction. Four of these
nine patients initially were thought to have idiopathic gastroparesis
, Electrogastrograms (EGGs) were recorded from 29 healthy subjects who
served as controls. EGGs were recorded for 20-30 min 2 h after a stan
dard 200-Kcal meal and were analyzed visually and by computer. Results
: Patients with gastroparesis due to outlet obstruction had high-ampli
tude and excessively regular 3-cycles-per-minute (cpm) EGG patterns, w
hereas patients with idiopathic gastroparesis had primarily 1- to 2-cp
m patterns and little 3-cpm EGG activity. The percentage of total EGG
power in the 3-cpm range was approximately 50% in patients with gastri
c outlet obstruction compared with 20% in patients with idiopathic gas
troparesis (p < 0.001). The percentage of EGG power in the normal 3-cp
m range was greater in the obstructed patients (50%) than in the healt
hy controls (35%;p < 0.052). Conclusions: Gastric myoelectrical patter
ns recorded in the EGG distinguish mechanical and idiopathic causes of
gastroparesis and may be useful in evaluating patients with nausea, v
omiting, and gastroparesis of unknown cause. (Am J Gastroenterol 1998;
93:1803-1809. (C) 1998 by Am. Cell. of Gastroenterology)