Abstract
Gastric emptying results from the co-ordinated contraction of antral, pyloric and duodenal smooth muscle. The rate of contraction is controlled by the electrical slow wave activity of smooth nuscle cells which originates from a pacemaker area in the body of the stomach and controls the orderly aboral propagation of gastric contents. Such electrical control activity (ECA) can be detected by conventional mucosa or serosal electromyographic techniques but more recently attempts have been made to record ECA non invasively using bipolar skin Ag/Ag Cl electrodes. The resultant electrogastrogram (EGG) has a very low signal to noise ratio and requires a variety of signal processing methods to reveal the underlying signal. We have measured ECA frequency from a fasting EGG in control subjects and 5 patients with delayed gastric emptying due to chronic intestinal pseudo-obstruction (CIP). The EGG was recorded for 1 hour using low pass filtering at 0.33 Hz, digitalised at 1 Hz and stored on a floppy disc. The stored signal was then band pass filtered (0.01-0.25 Hz) and a running spectral analysis carried out using Zenith 248 Computer. In control subjects a consistent gastric ECA of 3 cycles per min (cpm) was found. In 4 of the patients with a myopathic CIP, ECA frequency varied between 1-6 cpm with time and no clear consistent dominant frequency could be seen. In 1 patient with a neuropathic CIP a persistent tachyarrhythmia a16 cpm was seen. These data suggest that in smooth muscle disease ECA frequency wanders but alteration of the neurohumoral environment may result in an altered ECA frequency Such brady or tachy-arrhythmias result in gastric atony and delayed gastric emptying and raise the question of whether anti dysrrhythmic agent might be therapeutically more appropriate than conventional prokinetic drugs.
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Bisset, W., Devane, S. & Milla, P. 23 GASTRIC ANTRAL DYSRRHYTHMIAS – A CAUSE OF VOMITING. Pediatr Res 24, 409 (1988). https://doi.org/10.1203/00006450-198809000-00046
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DOI: https://doi.org/10.1203/00006450-198809000-00046