Simplifying the evaluation of postprandial antral motor function in patients with suspected gastroparesis.
OBJECTIVE
Antral hypomotility is associated with symptoms of gastric stasis[fnc,1.


OBJECTIVE
To quantitate antral motor function in patients with suspected gastroparesis due to idiopathic or secondary hypomotility; and to determine whether there are simpler indices to assess antral motility.


METHODS
Standard eight-lumen antroduodenal manometry was performed in 67 patients for 3-h fasting and 2-h postprandial measurements. Antral motility 1 cm proximal to the pylorus was quantitated for a 2-h fed period as an index: MI = ln[(number contractions x (amplitudes) + 1]. Fifteen healthy volunteers served as controls.


RESULTS
Forty-one patients had hypomotility and 26 normal antral motility, defined by a MI > or = 13.67. Patients with antral hypomotility due to a neuropathic (n = 17) or myopathic (n = 3) disorder showed a significantly lower MI (11.6 +/- 0.3 [SEM]; 95% confidence interval 11-12.1) compared with patients with idiopathic hypomotility (n = 21, MI = 12.5 +/- 0.2). There were fewer antral contractions postprandially in patients with secondary hypomotility than in idiopathic hypomotility (66 +/- 6 per 2 h vs 90 +/- 10; p < 0.05), and both were lower than in healthy controls (224 +/- 15). Mean amplitudes of antral contractions were similar for the neuropathic, idiopathic and control groups, but lower in myopathic (33 +/- 6 mm Hg) compared with neuropathic disorders (48 +/- 4 mm Hg; fifth percentile 30.6 mm Hg).


CONCLUSIONS
An antral MI < 12.1 should lead to a search for an underlying neuropathic or myopathic process; an average of less than 1 contraction per minute postprandially is a simple estimate of significant hypomotility. Antral contractions with a mean amplitude < 30 mm Hg suggest a myopathic disorder.
Thumshirn
M
M
Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota 55905, USA.
Bruninga
K
K
Camilleri
M
M
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications; D003109:Colonic Diseases, Functional / Q000150:complications; D016001:Confidence Intervals; D048909:Diabetes Complications; D004063:Digestion / Q000502:physiology*; D004386:Duodenum / Q000503:physiopathology; D004415:Dyspepsia / Q000150:complications; D004435:Eating / Q000502:physiology*; D005069:Evaluation Studies as Topic; D005215:Fasting / Q000502:physiology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005769:Gastrointestinal Motility / Q000502:physiology*; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009135:Muscular Diseases / Q000150:complications; D009422:Nervous System Diseases / Q000150:complications; D010528:Peristalsis / Q000502:physiology; D011312:Pressure; D011706:Pyloric Antrum / Q000502:physiology*; D011708:Pylorus / Q000503:physiopathology