title: Postprandial gastric antral contractions in patients with gastro-oesophageal reflux disease: a scintigraphic study.
abstract: Disturbed gastric contractility has been found in manometric studies in patients with gastro-oesophageal reflux disease (GORD), but the pathophysiological role of this abnormality is unclear. We aimed at assessing postprandial gastric antral contractions and its relationships with gastric emptying and gastro-oesophageal reflux in GORD patients. Fasted GORD patients (n = 13) and healthy volunteers (n = 13) ingested a liquid meal labelled with 72 MBq of 99mTechnetium-phytate. Gastric images were acquired every 10 min for 2 h, for measuring gastric emptying half time. Dynamic antral scintigraphy (one frame per second), performed for 4 min at 30-min intervals, allowed estimation of both mean dominant frequency and amplitude of antral contractions. In GORD patients (n = 10), acidic reflux episodes occurring 2 h after the ingestion of the same test meal were determined by ambulatory 24-h oesophageal pH monitoring. Gastric emptying was similar in GORD patients and controls (median; range: 82 min; 58-126 vs 80 min; 44-122 min; P = 0.38). Frequency of antral contractions was also similar in both groups (3.1 cpm; 2.8-3.6 vs 3.2 cpm; 2.4-3.8 cpm; P = 0.15). In GORD patients, amplitude of antral contractions was significantly higher than in controls (32.7%; 17-44%vs 23.3%; 16-43%; P = 0.01), and correlated positively with gastric emptying time (R(s) = 0.58; P = 0.03) and inversely with the number of reflux episodes (R(s) = -0.68; P = 0.02). Increased amplitude of postprandial gastric antral contractions in GORD may comprise a compensatory mechanism against delayed gastric emptying and a defensive factor against acidic gastro-oesophageal reflux.
authors.affiliation: Division of Gastroenterology and Section of Nuclear Medicine, Department of Medicine, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil.
authors.forename: C L A
authors.initials: CL
authors.lastname: Barbieri
authors.forename: L E A
authors.initials: LE
authors.lastname: Troncon
authors.forename: J R L
authors.initials: JR
authors.lastname: Herculano
authors.forename: L R O
authors.initials: LR
authors.lastname: Aprile
authors.forename: E R
authors.initials: ER
authors.lastname: Moraes
authors.forename: M
authors.initials: M
authors.lastname: Secaf
authors.forename: R O
authors.initials: RO
authors.lastname: Dantas
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D010528:Peristalsis / Q000502:physiology; D019518:Postprandial Period / Q000502:physiology*; D011706:Pyloric Antrum / Q000000981:diagnostic imaging* / Q000502:physiology*; D011877:Radionuclide Imaging / Q000379:methods; D013270:Stomach / Q000000981:diagnostic imaging / Q000502:physiology