METHODS: Consecutive adult patients (age ≥ 18 years) referred for gastric emptying scintigraphy (GES) were eligible for study inclusion. Patients were excluded if they had prior foregut surgery; were taking opioids or other medications known to affect gastric emptying; had a HgbA1C > 10; or were recently hospitalized. Three wireless motility patches were applied to the skin prior to GES. Patients wore the patches for 6 days while recording meals, symptoms, and bowel movements using an iPhone app.
RESULTS: Twenty-three consecutive adults (87% women; mean age = 43.9 years; mean BMI = 26.7 kg/m2) were enrolled. A gastric histogram revealed three levels of gastric myoelectric activity: weak, moderate, and strong. Patients with delayed gastric emptying at 4 h had weak gastric myoelectrical activity. Patients with nausea and vomiting had strong intestinal activity. Those with FD had weak gastric and intestinal myoelectric activity, and a weak meal response in the stomach, intestine, and colon compared to those with nausea alone or vomiting alone.
CONCLUSIONS: Patients with FD, and those with delayed gastric emptying, had unique gastrointestinal myoelectrical activity patterns. Reduced postprandial pan-intestinal myoelectric activity may explain the symptoms of FD in some patients. Recording gastrointestinal activity over a prolonged period in the outpatient setting has the potential to identify unique pathophysiologic patterns and meal-related activity that distinguishes patients with distinct gastric sensorimotor disease states.
方法:连续接受胃排空闪烁显像(GES)检查的成年患者(年龄≥18岁)符合纳入研究的条件。如果患者先前曾进行前肠手术;正在服用阿片类药物或其他已知会影响胃排空的药物;HgbA1C>10;或最近住院,则将其排除在外。在GES之前将三个无线运动贴片应用于皮肤。患者在记录进餐时戴了6天的贴片,症状,使用iPhone应用程序排便。
结果:纳入23名连续成年人(87%为女性;平均年龄=43.9岁;平均BMI=26.7kg/m2)。胃直方图显示胃肌电活动的三个水平:弱,中度,和强大。4小时胃排空延迟的患者胃肌电活动较弱。恶心和呕吐的患者有强烈的肠道活动。FD患者的胃和肠肌电活动较弱,胃里有微弱的进餐反应,肠,和结肠与单独恶心或单独呕吐的人相比。
结论:FD患者,那些胃排空延迟的人,有独特的胃肠肌电活动模式。餐后肠肌电活动减少可能解释某些患者的FD症状。在门诊环境中长时间记录胃肠道活动有可能识别独特的病理生理模式和膳食相关活动,从而区分具有不同胃感觉运动疾病状态的患者。