Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia

Abstract

Aim: To evaluate the effect of prokinetic drugs on electrogastrography (EGG) parameters according to symptomatic changes in patients with functional dyspepsia (FD).

Methods: Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010. We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment. We also measured cutaneous pre-prandial and post-prandial EGG recordings including percentage of gastric waves (normogastria, bradygastria, tachygastria), dominant frequency (DF), dominant power (DP), dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC), and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment.

Results: Fifty-two patients (70%) achieved symptomatic improvement after prokinetic drug treatment. Patients who had normal gastric slow waves showed symptom improvement group after treatment. Post-prandial DF showed a downward trend in the symptom improvement group, especially in the itopride group. Post-prandial DP was increased regardless of symptom improvement, especially in the itopride group and mosapride group. Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment. The EGG power ratio was increased after treatment in the symptom improvement group (0.50 ± 0.70 vs 0.93 ± 1.77, P = 0.002), especially in the itopride and levosulpiride groups.

Conclusion: Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity, and EGG could be a useful tool in evaluating the effects of various prokinetics.

Keywords: Electrogastrography; Functional dyspepsia; Itopride; Levosulpiride; Mosapride.

Figure 1

Proportion of gastric slow waves on electrogastrography. A: Pre-prandial; B: Post-prandial. ^aP < 0.05 vs pre-treatment.

Figure 2

Changes in dominant frequency and dominant power, dominant frequency instability coefficient and dominant power instability coefficient after prokinetic treatment. A: Dominant frequency (DF) in pre-prandial electrogastrography (EGG); B: DF in post-prandial EGG; C: Dominant power (DP) in pre-prandial EGG; D: DP in post-prandial EGG; E: Dominant frequency instability coefficient (DFIC) in pre-prandial EGG; F: DFIC in post-prandial EGG; G: Dominant power instability coefficient (DPIC) in pre-prandial EGG; H: DPIC in post-prandial EGG. ^aP < 0.05 vs pre-treatment.

Figure 3

Power ratio before and after the 8-wk course of treatment. ^aP < 0.05 vs pre-treatment.