Gastroparesis other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Gastroparesis}} | {{Gastroparesis}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{SSH}} | ||
==Overview== | ==Overview== | ||
Other diagnostic studies for [[diagnosis]] of gastroparesis include 13C-octanoic acid breath test, the SmartPill wireless motility capsule (WMC) system, and electrogastrography. All of them could measure the [[Stomach|gastric]] motility and recognize delayed [[Stomach|gastric]] emptying. Electrogastrography is useful for differentiating gastroparesis from [[Dyspepsia|functional dyspepsia]] by identifying underlying myoelectrical activity. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===Breath Test=== | ===Breath Test=== | ||
* 13C-octanoic acid breath test may be helpful for [[Diagnosis-related group|diagnosis]] of gastroparesis. Features of breath test suggestive of a diagnosis of gastroparesis include:<ref>{{cite journal |vauthors=Zahn A, Langhans CD, Hoffner S, Haberkorn U, Rating D, Haass M, Enck P, Stremmel W, Rühl A |title=Measurement of gastric emptying by 13C-octanoic acid breath test versus scintigraphy in diabetics |journal=Z Gastroenterol |volume=41 |issue=5 |pages=383–90 |year=2003 |pmid=12772050 |doi=10.1055/s-2003-39331 |url=}}</ref><ref name="TangFriedenberg2011">{{cite journal|last1=Tang|first1=Derek M.|last2=Friedenberg|first2=Frank K.|title=Gastroparesis: Approach, Diagnostic Evaluation, and Management|journal=Disease-a-Month|volume=57|issue=2|year=2011|pages=74–101|issn=00115029|doi=10.1016/j.disamonth.2010.12.007}}</ref><ref name="KochCalles-Escandón2015">{{cite journal|last1=Koch|first1=Kenneth L.|last2=Calles-Escandón|first2=Jorge|title=Diabetic Gastroparesis|journal=Gastroenterology Clinics of North America|volume=44|issue=1|year=2015|pages=39–57|issn=08898553|doi=10.1016/j.gtc.2014.11.005}}</ref> | |||
** Determining [[delayed gastric emptying]] | |||
** High [[Sensitivity (tests)|sensitivity]] and [[Validity (statistics)|validity]] | |||
** Positive correlation to [[Nuclear medicine|scintigraphy]] | |||
===The SmartPill wireless motility capsule (WMC) system === | ===The SmartPill wireless motility capsule (WMC) system === | ||
* The SmartPill is a small device in capsule form that can be swallowed and collects information from gastrointestinal tract. | * The SmartPill is a small device in capsule form that can be swallowed and collects information from the [[gastrointestinal tract]].<ref name="pmid24881810">{{cite journal |vauthors=Hasler WL |title=The use of SmartPill for gastric monitoring |journal=Expert Rev Gastroenterol Hepatol |volume=8 |issue=6 |pages=587–600 |year=2014 |pmid=24881810 |doi=10.1586/17474124.2014.922869 |url=}}</ref> | ||
* It is used to evaluate suspected delayed emptying in gastroparesis and functional dyspepsia. | * It is used to evaluate suspected [[Delayed gastric emptying|delayed emptying]] in gastroparesis and [[Dyspepsia|functional dyspepsia]] by measuring transit time in the [[stomach]], [[small intestine]], and [[Colon (anatomy)|colon]]. | ||
* It assess both regional and whole [[Gastrointestinal tract|gut]] transit by measuring temperature, [[pH]], and the pressure of its immediate surroundings.<ref name="pmid26908282">{{cite journal |vauthors=Saad RJ |title=The Wireless Motility Capsule: a One-Stop Shop for the Evaluation of GI Motility Disorders |journal=Curr Gastroenterol Rep |volume=18 |issue=3 |pages=14 |year=2016 |pmid=26908282 |doi=10.1007/s11894-016-0489-x |url=}}</ref> | |||
=== Electrogastrography === | |||
* Electrogastrography is used to evaluate [[Stomach|gastric]] electrical activity.<ref name="pmid16457127">{{cite journal |vauthors=Rossi Z, Forlini G, Fenderico P, Cipolla R, Nasoni S |title=Electrogastrography |journal=Eur Rev Med Pharmacol Sci |volume=9 |issue=5 Suppl 1 |pages=29–35 |year=2005 |pmid=16457127 |doi= |url=}}</ref><ref>{{cite journal |vauthors=Sanmiguel CP, Mintchev MP, Bowes KL |title=Electrogastrography: a noninvasive technique to evaluate gastric electrical activity |journal=Can. J. Gastroenterol. |volume=12 |issue=6 |pages=423–30 |year=1998 |pmid=9784898 |doi= |url=}}</ref> | |||
* Electrogastrography is useful for differentiating gastroparesis from [[Dyspepsia|functional dyspepsia]] by identifying underlying myoelectrical activity. | |||
===Antroduodenal manometry=== | |||
* In antroduodenal manometry, a water-perfused or solid-state [[Manometry|manometric]] catheter is passed from the nares/mouth and placed [[Fluoroscopy|fluoroscopically]] into the [[stomach]] and [[small bowel]] to measure the gastroduodenal contractile activity. | |||
* Motor patterns of gastroparesis in antroduodenal manometry includes:<ref name="pmid18081647">{{cite journal| author=Haans JJ, Masclee AA| title=Review article: The diagnosis and management of gastroparesis. | journal=Aliment Pharmacol Ther | year= 2007 | volume= 26 Suppl 2 | issue= | pages= 37-46 | pmid=18081647 | doi=10.1111/j.1365-2036.2007.03534.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18081647 }}</ref><ref name="pmid19115465">{{cite journal| author=Waseem S, Moshiree B, Draganov PV| title=Gastroparesis: current diagnostic challenges and management considerations. | journal=World J Gastroenterol | year= 2009 | volume= 15 | issue= 1 | pages= 25-37 | pmid=19115465 | doi= | pmc=2653292 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19115465 }}</ref> | |||
** [[Postprandial]] [[Antrum|antral]] hypomotility due to infrequent contractions and/or low amplitudes | |||
** Abnormal propagation of antroduodenal contractions | |||
** Increased [[Pylorus|pyloric]] spasms which are characterized by an increased tonic and phasic activity | |||
** Abnormal migrating motor complexes (MMC), less frequently originating from the [[stomach]] | |||
==References== | ==References== | ||
Latest revision as of 16:17, 20 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Other diagnostic studies for diagnosis of gastroparesis include 13C-octanoic acid breath test, the SmartPill wireless motility capsule (WMC) system, and electrogastrography. All of them could measure the gastric motility and recognize delayed gastric emptying. Electrogastrography is useful for differentiating gastroparesis from functional dyspepsia by identifying underlying myoelectrical activity.
Other Diagnostic Studies
Breath Test
- 13C-octanoic acid breath test may be helpful for diagnosis of gastroparesis. Features of breath test suggestive of a diagnosis of gastroparesis include:[1][2][3]
- Determining delayed gastric emptying
- High sensitivity and validity
- Positive correlation to scintigraphy
The SmartPill wireless motility capsule (WMC) system
- The SmartPill is a small device in capsule form that can be swallowed and collects information from the gastrointestinal tract.[4]
- It is used to evaluate suspected delayed emptying in gastroparesis and functional dyspepsia by measuring transit time in the stomach, small intestine, and colon.
- It assess both regional and whole gut transit by measuring temperature, pH, and the pressure of its immediate surroundings.[5]
Electrogastrography
- Electrogastrography is used to evaluate gastric electrical activity.[6][7]
- Electrogastrography is useful for differentiating gastroparesis from functional dyspepsia by identifying underlying myoelectrical activity.
Antroduodenal manometry
- In antroduodenal manometry, a water-perfused or solid-state manometric catheter is passed from the nares/mouth and placed fluoroscopically into the stomach and small bowel to measure the gastroduodenal contractile activity.
- Motor patterns of gastroparesis in antroduodenal manometry includes:[8][9]
- Postprandial antral hypomotility due to infrequent contractions and/or low amplitudes
- Abnormal propagation of antroduodenal contractions
- Increased pyloric spasms which are characterized by an increased tonic and phasic activity
- Abnormal migrating motor complexes (MMC), less frequently originating from the stomach
References
- ↑ Zahn A, Langhans CD, Hoffner S, Haberkorn U, Rating D, Haass M, Enck P, Stremmel W, Rühl A (2003). "Measurement of gastric emptying by 13C-octanoic acid breath test versus scintigraphy in diabetics". Z Gastroenterol. 41 (5): 383–90. doi:10.1055/s-2003-39331. PMID 12772050.
- ↑ Tang, Derek M.; Friedenberg, Frank K. (2011). "Gastroparesis: Approach, Diagnostic Evaluation, and Management". Disease-a-Month. 57 (2): 74–101. doi:10.1016/j.disamonth.2010.12.007. ISSN 0011-5029.
- ↑ Koch, Kenneth L.; Calles-Escandón, Jorge (2015). "Diabetic Gastroparesis". Gastroenterology Clinics of North America. 44 (1): 39–57. doi:10.1016/j.gtc.2014.11.005. ISSN 0889-8553.
- ↑ Hasler WL (2014). "The use of SmartPill for gastric monitoring". Expert Rev Gastroenterol Hepatol. 8 (6): 587–600. doi:10.1586/17474124.2014.922869. PMID 24881810.
- ↑ Saad RJ (2016). "The Wireless Motility Capsule: a One-Stop Shop for the Evaluation of GI Motility Disorders". Curr Gastroenterol Rep. 18 (3): 14. doi:10.1007/s11894-016-0489-x. PMID 26908282.
- ↑ Rossi Z, Forlini G, Fenderico P, Cipolla R, Nasoni S (2005). "Electrogastrography". Eur Rev Med Pharmacol Sci. 9 (5 Suppl 1): 29–35. PMID 16457127.
- ↑ Sanmiguel CP, Mintchev MP, Bowes KL (1998). "Electrogastrography: a noninvasive technique to evaluate gastric electrical activity". Can. J. Gastroenterol. 12 (6): 423–30. PMID 9784898.
- ↑ Haans JJ, Masclee AA (2007). "Review article: The diagnosis and management of gastroparesis". Aliment Pharmacol Ther. 26 Suppl 2: 37–46. doi:10.1111/j.1365-2036.2007.03534.x. PMID 18081647.
- ↑ Waseem S, Moshiree B, Draganov PV (2009). "Gastroparesis: current diagnostic challenges and management considerations". World J Gastroenterol. 15 (1): 25–37. PMC 2653292. PMID 19115465.