Electrogastrography in cyclic vomiting syndrome

Children with cyclic vomiting syndrome have a characteristic periodicity, a nd this could be due to abnormal gastric myoelectrical activity detectable by cutaneous electrogastrography (EGG). Fifteen children, aged 4-15 years, with CVS (eight symptomatic and seven asymptomatic at the time of study) un derwent EGG and we-re compared to five normal and four disease control chil dren. The relative tachygastria activity (RTA) or power ratio was calculate d in each group. Five of the eight symptomatic CVS children showed marked e pisodes of tachygastria preprandially and all showed tachygastria postprand ially. The asymptomatic CVS children showed tachygastria only postprandiall y after the test meal. RTA index and or power ratio of symptomatic children was significantly different from the asymptomatic CVS children (P = 0.001) , normal (P = 0.007) and disease control children (P = 0.006). In a subsequ ent study, 2-hr gastric emptying Tc-99m scintiscans were performed in 28 CV S children and compared to eight healthy control children. Twelve of 16 CVS children (75%) showed abnormal gastric emptying, and 7 of 28 (25%) showed abnormal EGG with significant tachygastria. The CVS children had significan tly higher RTA both preprandially (P < 0.05) and postprandially (P < 0.05). Our results demonstrate that accelerated gastric rhythm was seen during th e acute episodes of half of the CVS patients studied. Abnormal EGGs and hig her RTA or power ratios were associated with delayed gastric emptying in th e CVS children. Abnormal gastric myoelectrical activity may play a role in the pathogenesis of CVS syndrome.