Reproducibility of gastric barostat studies in healthy controls and in dyspeptic patients

OBJECTIVES: Gastric barostat studies are increasingly being performed, but their reproducibility and the most suitable study protocol have not been de termined. The aim of this study was to verify the reproducibility of gastri c sensitivity and accommodation testing in healthy and in dyspeptic subject s, and to compare stepwise and double random staircase distensions. METHODS: A total of 13 dyspeptic patients and 25 healthy control subjects u nderwent two successive studies. Sensory thresholds were assessed on a same -day/different-days protocol, using a stepwise (11/14 healthy subjects and 11/13 patients) or a double random staircase inflation (11/21 healthy subje cts). In 10 healthy subjects, both methods were compared. Gastric accommoda tion was measured on different days in 13 patients and nine healthy subject s. Data (mean +/- SEM) were compared using the paired t test, and individua l variability was expressed as the percent coefficient of variation. RESULTS: In healthy subjects, the thresholds for first perception and for d iscomfort were highly reproducible (p > 0.05) and the pressure thresholds s howed a lower degree of variability than the volumes. Pressure thresholds q uantified by stepwise showed lower variability than double random staircase inflation. In the patients, the sensory thresholds were unchanged between the sessions on the same and on different days (p > 0.05). Gastric accommod ation also showed excellent reproducibility for both dyspeptic patients and healthy control subjects (p > 0.05). CONCLUSIONS: Both in dyspeptic patients and in healthy control subjects, ga stric sensitivity and accommodation quantified by isobaric distensions show excellent reproducibility. Pressure and volume thresholds both are well re producible, but the former shows less variability. Finally, the simplest st epwise protocol is better than the double random staircase to assess the ga stric sensitivity to distension. (Am J Gastroenterol 2001;96:1037-1053. (C) 2001 by Am. Coll. of Gastroenterology).