Abstract
Abnormalities in the gastric pacemaker potentials occur in patients with impaired gastric emptying. It is unclear if treatment effects the underlying rhythm or if normalization of dysrhythmias is important. We examined the effect of cisapride using surface electrogastrograms and radionuclide gastric emptying studies of patients with idiopathic and diabetic gastroparesis. Twelve of 14 patients had abnormal baseline electrogastrograms. After six months of cisapride, four patients had normalization of their electrical activity and six had improvement. Patients with idiopathic gastroparesis had an increase in gastric emptying at 120 min from 48.9±3.8% (baseline) to 70.9±6.0% (six months), P =0.009. Patients with diabetes mellitus had a similar improvement. Patients who had normalization of the electrogastrogram had a greater gastric emptying rate than patients with continued dysrhythmias. Thus, dysrhythmias are important in the etiology for gastroparesis, but other factors need to be examined.
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References
Geldof M, Van Der Schee EJ, Van Blankenstein M, Grashuis JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 27:799–808, 1986
Koch KL, Stern RM, Stewart WR, Vasey MW: Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: Effect of long-term domperidone treatment. Am J Gastroenterol 84:1069, 1989
Jian R, Ducrot F, Piedeloup C, Mary JY, Najean Y, Bernier JJ: Measurement of gastric emptying in dyspeptic patients: Effect of a new gastrokinetic agent (cisapride). Gut 26:352–358, 1985
McCallum RW: Cisapride: A new class of prokinetic agent. Am J Gastroenterol 86:135, 1991
Horowitz M, Maddox A, Harding PE, Maddern GJ, Chatterton BE, Wishart J, Shearman DJC: Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus. Gastroenterology 92:1899–1907, 1987
Velchik MG, Reynolds JC, Alavi A: The effect of meal energy content on gastric emptying. J Nucl Med 30:1106, 1989
Hamilton JW, Bellahsene BE, Reichelderfer M, Webster JG, Bass P: Human electrogastrograms: Comparison of surface and mucosal recordings. Dig Dis Sci 31:33–39, 1986
Smout AJPM, van der Schee EJ, Grashius JL: What is measured in electrogastrography? Dig Dis Sci 25:179–186, 1980
Stern RM, Koch KL, Stewart WR, Vasey MW: Electrogastrography: Current issues in validation and methodology. Psychophysiology 24:55–64, 1987
Kim CH, Zinsmeister AR, Malagelada JR: Mechanisms of canine gastric dysrhythmia. Gastroenterology 92:993–999, 1987
Kim CH, Azpiroz F, Malagelada JR: Characteristics of spontaneous and drug induced gastric dysrhythmias in a chronic canine model. Gastroenterology 90:421–427, 1987
You CH, Lee KY, Chey WY, Menguy R: Electrogastrographic study of patients with unexplained nausea, bloating, and vomiting. Gastroenterology 9:311–314, 1980
You CH, Chey WY, Lee KY, Menguy R, Bortoff A: Gastric and small intestinal myoelectrical dysrhythmia associated with chronic intractable nausea and vomiting. Ann Intern Med 95:449–451, 1981
Abell TL, Camilleri M, Malagelada JR: High prevalence of gastric electrical dysrhythmias in diabetic gastroparesis. Gastroenterology 88:1300, 1985 (abstract)
Telander RL, Morgan KG, Kreulen DL, Schmalz PF, Kelly KA, Szurszewski J: Human gastric atony with gastric atony and tachygastria and gastric retention. Gastroenterology 75:497–501, 1978
Camilleri M, Malagelada JR, Abell TL, Brown ML, Hench V, Zinsmeister AR: Effect of six weeks of treatment with cisapride in gastroparesis and intestinal pseudoobstruction. Gastroenterology 96:704, 1989
Havelund T, Øster-Jørgensen E, Eshøj O, Larsen ML, Lauritsen K: Effects of cisapride on gastroparesis in patients with insulin-dependent diabetes mellitus. Acta Med Scand 222:339, 1987
Feldman M, Smith HJ: Effect of cisapride on gastric emptying of indigestible solids in patients with gastroparesis diabeticorum. Gastroenterology 92:171, 1987
Snape WJ, Battle WM, Schwartz SS, Braunstein SN, Goldstein HA, Alavi A: Metoclopramide to treat gastroparesis due to diabetes mellitus. Ann Intern Med 96:444, 1982
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This work was in part supported by the Measey Foundation, by NIH grant R01-DK389641-01 A1, and by the Janssen Research Foundation.
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Rothstein, R.D., Alavi, A. & Reynolds, J.C. Electrogastrography in patients with gastroparesis and effect of long-term cisapride. Digest Dis Sci 38, 1518–1524 (1993). https://doi.org/10.1007/BF01308614
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DOI: https://doi.org/10.1007/BF01308614