Emerging techniques in the evaluation of gastric motility and gastric afferent sensation

Development of gastric slow waves and effects of feeding in pre-term and full-term infants

The aims of this study were to investigate the difference in developmental process of gastric slow waves and the effects of feeding in pre-term and full-term infants. Twenty-six pre-term and 31 full-term infants were enrolled in the study. Gastric myoelectrical activity was recorded using electrogastrography (EGG) from birth to month 6. An increase in the % of 2-4 cpm slow waves was noted in both pre-term (P < 0.01) and full-term infants (P < 0.04) from birth to month 4. The pre-term infants showed a reduced dominant EGG power at certain points of the study. (3) Breast or formula feeding resulted in no difference in the EGG in the full-term infants and showed a difference in the postprandial dominant power of the EGG in the pre-term infants only at month 2 after birth (P < 0.05) but not at other times. The gastric slow wave in pre-term infants is of a significantly reduced amplitude but similar rhythmicity. The method of feeding has no effects on the EGG in full-term infants and minimal effects (may be of non-clinical significance) on the EGG in pre-term infants as the difference was noted only at one time point during the 6-month follow-up study.

Gastric emptying in infants: epigastric impedance versus scintigraphy

AIM

To compare epigastric impedance versus scintigraphy in monitoring the gastric emptying of the same adapted milk formula in infants.

METHODS

Seven infants with clinical symptoms of gastric motility disease underwent scintigraphy with 99mTc sulphur colloid for the 90 min following the ingestion of the same adapted milk formula, in order to evaluate gastric emptying. A bio-impedance device, connected to a PC, was prepared for this purpose with four standard electrodes placed anteriorly on the upper part of the body. The obtained graphs were compared to those of the scintigraphic method. Statistical analysis was performed using Pearson correlation. The confidence limits were set at 95%. Parental consent was obtained before each analysis.

RESULTS

The gastric emptying patterns obtained with epigastric impedance were closely correlated to those shown by the scintigraphy (r = 0.86 +/- 0.08; p < 0.05). A significant correlation between the gastric emptying velocity measured by the two techniques was found (r = 0.94; p = 0.002).

CONCLUSIONS

Epigastric impedance in infants provided estimates of gastric emptying that were closely correlated with scintigraphy. However, the limits derived from the epigastric impedance suggest that, at the moment, the two methods should not be used interchangeably.