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Soliman H, Wuestenberghs F, Desprez C, Leroi AM, Melchior C, Gourcerol G. Physiological characterization of gastric emptying using high-resolution antropyloroduodenal manometry. Am J Physiol Gastrointest Liver Physiol 2024; 326:G16-G24. [PMID: 37874655 DOI: 10.1152/ajpgi.00101.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 10/26/2023]
Abstract
Delayed gastric emptying (GE) has been associated with antral and pyloric dysmotility. We aimed to characterize differences in the antral, duodenal, and pyloric motility profiles associated with delayed GE, using high-resolution antropyloroduodenal manometry (HR-ADM). Patients referred for HR-ADM for dyspeptic symptoms performed a concurrent GE breath test (NCT01519180 and NCT04918329). HR-ADM involved 36 sensors 1 cm apart, placed across the pylorus. Interdigestive and postprandial periods were identified. Antral, pyloric, and duodenal motor profiles were analyzed recording the frequency, amplitude, and propagative nature of contractions for each period. Plots of patients with normal and delayed GE were compared. Sixty patients underwent both HR-ADM and GE tests. Twenty-five and 35 patients had delayed and normal GE, respectively. Antral and duodenal motor profiles were not different between the two groups during the interdigestive period. During the postprandial period, a lower frequency of antral contractions was associated with delayed GE (2.22 vs. 1.39 contractions/min; P = 0.002), but no difference in mean contraction amplitude was observed. The pyloric region was identified in all the patients and pylorospasms, defined as 3 min of repeated isolated pyloric contractions, were more frequent in patients with delayed GE (32.0% vs. 5.7%; P = 0.02) during the postprandial period. No difference in duodenal contraction profiles was observed. Manometric profile alterations were observed in 72% of the patients with delayed GE, with 56% having a low frequency of antral contractions. Using HR-ADM, patients with delayed GE displayed different postprandial antropyloric motility as compared with patients with normal GE.NEW & NOTEWORTHY High-resolution antropyloroduodenal manometry (HR-ADM) allows precise characterization of antral, pyloric, and duodenal motility, although its association with gastric emptying (GE) has been poorly investigated. Concurrent HR-ADM with GE measurement showed a lower frequency of antral postprandial contractions and an increased frequency of postprandial pylorospasms in patients with delayed GE. HR-ADM could, therefore, be useful in the future to better select patients for treatments targeting the pylorus.
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Affiliation(s)
- Heithem Soliman
- Department of Physiology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
- Department of Gastroenterology, Université de Paris-Cité, Hôpital Louis Mourier, Colombes, France
| | - Fabien Wuestenberghs
- Department of Physiology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
- Department of Gastroenterology, Hôpital Avicenne, Sorbonne Paris Nord University, Bobigny, France
| | - Charlotte Desprez
- Department of Physiology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
| | - Anne-Marie Leroi
- Department of Physiology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
| | - Chloé Melchior
- Department of Gastroenterology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
| | - Guillaume Gourcerol
- Department of Physiology, Université Rouen Normandie, INSERM, ADEN UMR1073, "Nutrition, Inflammation and Microbiota-Gut-Brain Axis," CHU Rouen, Rouen, France
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Wang Y, Chen JDZ, Nojkov B. Diagnostic Methods for Evaluation of Gastric Motility-A Mini Review. Diagnostics (Basel) 2023; 13:803. [PMID: 36832289 PMCID: PMC9955554 DOI: 10.3390/diagnostics13040803] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/11/2023] [Accepted: 02/18/2023] [Indexed: 02/23/2023] Open
Abstract
Gastric motility abnormalities are common in patients with disorders of gut-brain interaction, such as functional dyspepsia and gastroparesis. Accurate assessment of the gastric motility in these common disorders can help understand the underlying pathophysiology and guide effective treatment. A variety of clinically applicable diagnostic methods have been developed to objectively evaluate the presence of gastric dysmotility, including tests of gastric accommodation, antroduodenal motility, gastric emptying, and gastric myoelectrical activity. The aim of this mini review is to summarize the advances in clinically available diagnostic methods for evaluation of gastric motility and describe the advantages and disadvantages of each test.
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Affiliation(s)
| | | | - Borko Nojkov
- Division of Gastroenterology, University of Michigan, Ann Arbor, MI 48109, USA
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Kuhar S, Lee JH, Seo JH, Pasricha PJ, Mittal R. Effect of stomach motility on food hydrolysis and gastric emptying: Insight from computational models. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2022; 34:111909. [PMID: 36407285 PMCID: PMC9667910 DOI: 10.1063/5.0120933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The peristaltic motion of stomach walls combines with the secretion of digestive enzymes to initiate the process that breaks down food. In this study, the mixing, breakdown, and emptying of a liquid meal containing protein is simulated in a model of a human stomach. In this model, pepsin, the gastric enzyme responsible for protein hydrolysis, is secreted from the proximal region of the stomach walls and allowed to react with the contents of the stomach. The velocities of the retropulsive jet induced by the peristaltic motion, the emptying rate, and the extent of hydrolysis are quantified for a control case as well as for three other cases with reduced motility of the stomach, which may result from conditions such as diabetes mellitus. This study quantifies the effect of stomach motility on the rate of food breakdown and its emptying into the duodenum and we correlate these observations with the mixing in the stomach induced by the wall motion.
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Affiliation(s)
- Sharun Kuhar
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA
| | | | | | - Pankaj J Pasricha
- Division of Gastroenterology and Hepatology, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA
| | - Rajat Mittal
- Author to whom correspondence should be addressed:
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