Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: effect of long-term domperidone treatment.
We measured gastric emptying and gastric myoelectrical activity with solid-phase gastric-emptying tests and cutaneously recorded electrogastrograms (EGGs), respectively, in six insulin-dependent diabetic patients with nausea and vomiting who did not respond to standard treatments. Baseline solid phase gastric emptying was markedly delayed (78 +/- 8% retained at 120 min) and EGG recordings revealed gastric dysrhythmias; tachygastria (4-9 cpm signals) in one patient, 1- to 2-cpm waves in two patients, and flatline patterns in three patients. No patient had a normal 3-cpm EGG pattern. After 6 months of domperidone treatment, mean upper gastrointestinal symptoms scores decreased from 17.8 to 3.7 (p less than 0.01), and normal 3-cpm EGG frequencies were recorded from each of the six patients. The mean percentage of meal retained at 120 min decreased but did not improve significantly. Thus, establishment of normal 3-cpm gastric myoelectric activity and resolution of dysrhythmias, not normalization of emptying rates, was associated with improvement in upper gastrointestinal symptoms in these diabetic patients.
Department of Medicine, Pennsylvania State University, Hershey.
K L
KL
Koch
R M
RM
Stern
W R
WR
Stewart
M W
MW
Vasey
D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004294:Domperidone / Q000627:therapeutic use*; D004594:Electrophysiology; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D013270:Stomach / Q000503:physiopathology*; D013272:Stomach Diseases / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D004294:Domperidone