[Electrogastrography monitoring of the effectiveness of prokinetic and cognitive therapy in functional dyspepsia].
BACKGROUND
Evidence based management of functional gastrointestinal disorders is a controversial issue.


OBJECTIVE
The purpose of this work was to evaluate electrogastrography (EGG) monitoring of the different treatment modalities in functional dyspepsia patients.


METHODS
45 patients with functional dyspepsia were entered into the study. Dominant frequency was calculated from recorded contractions/min (cpm) and classified according to international standards: bradygastria (0.0-2.0 cpm), normal (2 < x < 4 cpm) and tachygastria (4-10 cpm). Results were compared to healthy controls. In 10 pts out of 45 with functional dyspepsia, a normal EGG was found. The monitoring of the treatment modalities was performed in the remaining 35 cases with abnormal EGG values.


RESULTS
20 out of 35 patients received 10 mg cisapride three times-daily for two weeks, that resulted in amelioration of dyspepsia symptoms and a parallel improvement in EGG parameters in 18 patients. During the 30 min preprandial period the frequency of bradygastria diminished (10.9 vs. 1.6%), while the rate of normal contractions raised (80.2 vs. 95.4%) significantly, after the 2 weeks cisapride treatment. Postprandial measurements showed similar, but not significant changes (bradygastria 4.2 vs. 2.8%, normogastria 85.2 vs. 95.0%). In 15/35 patients with functional dyspepsia severe depression or anxiety was diagnosed and cognitive therapy or relaxation training were applied without medical treatment. Symptoms, as well as EGG dysrhythmia ameliorated parallelly, the rate of preprandial normogastria showed a significant (85.2 vs. 95.0%) elevation.


CONCLUSIONS
The authors' results support that the EGG can be a suitable, simple, non-invasive and an easy to repeat method for the objective assessment of treatment efficacy in functional dyspepsia patients.
Fodor
Györgyi
G
MAV Kórház és Központi Rendelointézet, Gasztroenterológiai Osztály, Budapest.
Schwab
Richárd
R
Gyökeres
Tibor
T
Pap
Akos
A
D000328:Adult; D020117:Cisapride / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D004576:Electromyography; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D012064:Relaxation Therapy
D005765:Gastrointestinal Agents; D020117:Cisapride