Podstawowe zasady badania oraz znaczenie kliniczne elektrogastrografii (EGG) u dzieci i dorosłych -- konsensus wrocławski

Iwańczak, Barbara; Pytrus, Tomasz; Fyderek, Krzysztof; Kaczmarski, Maciej; Uścinowicz, Mirosława; Jonderko, Krzysztof Paweł; Mazur, Marcel; Semianów-Wejchert, Jarosława; Waśko-Czopnik, Dorota; Ksiądzyna, Dorota; Wąsowska-Królikowska, Krystyna; Parzęcka, Monika; Romańczuk, Bartosz; Iwańczak, Franciszek; Paradowski, Leszek
March 2010
Gastroenterologia Polska / Gastroenterology;2010, Vol. 17 Issue 2, p105
Academic Journal
Introduction: Electrogastrography (EGG) is a noninvasive diagnostic method recording gastric electrical activity with electrodes affixed to the abdominal wall overlying the stomach. The paper presents consensus on EGG with respect to indications, methodics, interpretation of the results in different age groups, as well as advantages and possible limitations of this diagnostic method reached by a panel of experts from leading Polish gastrointestinal clinics (children and adults) and research centres frequently applying this highly sophisticated technique who met at the 1st National Symposium on the Importance of Electrogastrography in Clinical Practice in Wroctaw on 12th of December 2009. Indications: According to the experts, EGG might be of some value in diagnostics and follow-up, predominantly in a variety of functional gastrointestinal disorders like irritable bowel syndrome, functional dyspepsia, aerophagia, cyclic vomiting syndrome, functional abdominal pain, functional diarrhea, functional constipation, nonretentive encopresis and some organic disorders, e.g. gastroesophageal reflux disease, diabetic and idiopathic gastroparesis, chronic intestinal pseudo-obstruction, postoperative and drug-induced dismotility, cystic fibrosis, hyper-/hypothyreosis, Parkinson's disease, anorexia nervosa/bulimia nervosa or renal failure. Methodics: Proper recording requires a set of optimal conditions like a warm and quiet room, thorough skin preparation and comfortable but relatively motionless supine or slightly reclining position. Typical EGG, usually carried out after withdrawal of agents affecting gastric motility prior to examination, consists of a fasting recording for 30-60 minutes followed by a short break for food intake (a test meal) and then postprandial examination lasting from 60 to 120 minutes. Interpretation of the results: Raw signals obtained during the examination undergo a visual and computer evaluation. The analysis of parameters characteristic for a traditional single channel EGG like dominant frequency (DF), dominant power (DP) or power ratio (PR) enables to define the final recordings as normogastria (2.4-3.7 cycles per minute - cpm), bradygastria (<2.4 cpm), tachygastria (>3.7 cpm), non-specific rhythm pattern, lack of postprandial power increase or uninterpretable waveform due to, for example, motion artefacts or other technical problems. Normal values may differ according to age of the patient. Uncoupling of slow waves, defined as the lack of synchronization between different parts of the stomach, is what a novel method known as multi-channel EGG can show due to simultaneous recording of signals with a help of four channels. In addition, multi-channel EGG enriched the range of parameters to be interpreted and striving for its application should be advised. However, clinical significance of some of these new indices deserves further study. Advantages and disadvantages of EGG: EGG is a noninvasive, relatively easy to perform and repeatable diagnostic method and, most likely, a valuable complementary tool in diagnostics and monitoring of the treatment of motility disorders in both children and adults. Nevertheless, EGG neither diagnoses unequivocally any specific disease nor is a substitute for other diagnostic modalities like a manometric study or scintigraphy. Moreover, EGG results may not enhance the currently available choice of medical therapy. In spite of the fact that the list of its indications is growing fast, there are still a lot of questions to be answered (selection of a test meal, quality improvement in signal acquisition, positive impact of the disclosed abnormalities on the management of affected patients, characteristics of the pathophysiology of EGG dysrhythmias, clinical significance of transient dysrhythmias, etc.).


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