Electrogastrography as diagnostic test in patients with gastric ischemia.

Veldhuis, K. (Kasper) (2013) Electrogastrography as diagnostic test in patients with gastric ischemia. thesis, Medicine.

Text VeldhuisK.pdf Restricted to Registered users only Download (2MB)

Abstract

Background: Determining whether a patient is suffering from gastrointestinal ischemia is not based on identifying stenotic lesions in the splanchnic arteries alone due to the vast collateral network. A function test for detecting ischemia, such as the validated pCO2 tonometry, is needed whether the stenosis also causes ischemia. However, this tonometry test is time consuming, cumbersome and expensive. In this study we explored whether changes in the electrical activity in the stomach can be used to diagnose gastrointestinal ischemia. Methods: In this prospective explorative research the electrogastrographic (EGG) recordings from healthy volunteers (HV) and patients suffering from gastric ischemia following a test meal were recorded. We used 20 cutaneous electrodes placed on the gastric region of the abdomen. Measurements were made during 30 min baseline, and up to two hours after a standard test meal (Nutridrink 400ml). The healthy controls were measured on two separate days within a one month period to assess reproducibility of EGG recordings. From the EGG recordings we performed, frequencies were analyzed in 30- and 5- minute periods. Further, we asked all subjects (HV, gastric ischemia patients, jejunal ischemia patients and non-ischemia (group with symptoms but no ischemia)) to score their abdominal symptoms (fullness, epigastric pain, bloating, belching, nausea, epigastric burning) every 15 minutes on a four point scale to relate complaints to EGG occurrences and to investigate symptom trends. Results: We included 8 healthy volunteers and 8 gastric ischemia patients for EGG frequency analysis. At 30-minute recordings, no difference is seen in most frequent dominant frequency between periods (P=0.076) in HV’s. Within the ischemia group there was a significant difference between the time intervals (P=0.005). However in the post-hoc measurements (Sidak), this difference disappeared due to correction from multiple testing. When type of patient is tested as independent variable in the repeated measurements, no significance was found (P = 0.402). Repeated measurement testing was not possible in the 5-minute recordings due to smaller amounts of observations in comparison to number of parameters but descriptive statistics show similar results to the 30-minute intervals. Symptom score results from forty-six people were allocated in four groups (HV’s, gastric-, jujunal-, and non-ischemia patients). Non-ischemia patients (group with symptoms but no ischemia) had higher postprandial mean symptom scores for all symptoms after 120 minutes in comparison to the ischemia groups. Fullness and epigastric pain were the most severe complaints in all groups. Conclusions: Frequency analysis did not reveal differences between healthy volunteers and ischemia patients, and therefore does not qualify as diagnostic test for the detection of gastric ischemia. Moreover, the electrogastrogram was not reproducible for both lead number and most frequent dominant frequency when comparing two measurement days done in a healthy volunteers. Symptom score is of limited value for distinguishing ischemia from non-ischemia.

Item Type:	Thesis (Thesis)
Supervisor name:	Kolkman, Prof. Dr. J. J.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:42
Last Modified:	25 Jun 2020 10:42
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/361

Actions (login required)

View Item