Antroduodenal manometry: 24-hour ambulatory monitoring versus short-term stationary manometry in patients with functional dyspepsia.
OBJECTIVE
To examine the interdigestive and postprandial antroduodenal motility patterns of patients with functional dyspepsia using prolonged ambulatory antroduodenal manometry and to compare these findings with conventional stationary manometry.


METHODS
Prolonged ambulatory and short-term stationary antroduodenal manometry were performed in 10 patients with functional dyspepsia and in 10 healthy volunteers (controls).


RESULTS
During stationary manometry only a few interdigestive motor complex (MMC) cycles were recorded. Using the ambulatory technique, fewer MMC cycles were observed in patients than in controls (2.2 +/- 0.63 and 4.1 +/- 0.54, respectively; P = 0.030). During phase II of the MMC, both techniques showed a higher antral motility index in patients (P = 0.017 and P = 0.049 for stationary and ambulatory manometry, respectively). The postprandial antral motility index was similar for patients and controls using stationary manometry. With the ambulatory technique, the antral motility index 1-1.5 h after breakfast was lower in patients than in controls (P = 0.020). Both techniques showed that the patients had a higher duodenal motility index after dinner and after breakfast (P < 0.05). Both techniques revealed more burst activity in patients than in controls (stationary: 10.7 versus 1.8% of the time; ambulatory: 1.7 versus 0.2% of the time; P = 0.004 and P = 0.051, respectively). Using a 10-min window period before the onset of symptoms, seven symptom episodes (33.3%) were found to be related to burst activity and retrograde or non-propagated phase III activity.


CONCLUSIONS
Ambulatory manometry is superior to stationary manometry for evaluating patients with functional dyspepsia, because patients can be studied for a prolonged period (allowing adequate evaluation of interdigestive abnormalities) and under physiological conditions. Prolonged monitoring also allows assessment of the relationship between symptoms and motor abnormalities.
Jebbink
R J
RJ
Department of Gastroenterology, University Hospital Utrecht, The Netherlands.
vanBerge-Henegouwen
G P
GP
Akkermans
L M
LM
Smout
A J
AJ
D000328:Adult; D004386:Duodenum / Q000503:physiopathology*; D004415:Dyspepsia / Q000503:physiopathology*; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D018670:Monitoring, Ambulatory; D011706:Pyloric Antrum / Q000503:physiopathology*