Skip to main content
Log in

Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia report of three cases

  • Case Report
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Summary

Three children (ages 5, 7.6, and 8 years), with recurrent unexplained upper abdominal symptoms such as vomiting, epigastric pain, anorexia, early satiety and without structural or mucosal abnormalities of gastrointestinal tract, underwent electrogastrography (EGG)—recording of gastric electrical activity using cutaneous electrodes positioned on the epigastric region and connected to a recording polygraph. Frequency of EGG signals was analyzed by fast Fourier transform. Significant changes of fasting and fed gastric myoelectrical activity (tachygastria, bradygastria, flatline pattern) were recorded in the three patients; furthermore, gastric emptying (GE) of a solid-liquid mixed meal, measured by ultrasonography, was significantly prolonged in them. A follow-up study was carried out after an eight-week course with oral cisapride: in all patients symptoms improved, GE time normalized, and EGG analysis showed normal electrical rhythm. It is suggested that gastric dysrhythmias can play a pathogenetic role in patients with functional gastrointestinal symptoms and that symptomatic improvement is accompanied by normalization of gastric electrical rhythm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lennard-Jones JE: Functional gastrointestinal disorders. N Engl J Med 308:431–435, 1983

    Google Scholar 

  2. Heatley RV, Rathbone BJ: Dyspepsia: A dilemma for doctors? Lancet 2:779–781, 1987

    Google Scholar 

  3. Mathias JR, Finelli DS: Functional diseases of the small intestine.In Functional Disorders of the Gastrointestinal Tract. S Cohen, R Soloway (eds). New York, Churchill Livingstone, 1987, pp 39–58

    Google Scholar 

  4. Malagelada JR, Stanghellini V: Manometric evaluation of functional upper gut symptoms. Gastroenterology 88:1223–1331, 1985

    Google Scholar 

  5. Pineiro-Carrero VM, Andres JM, Davis RH, Mathias JR: Abnormal gastrointestinal motility in children and adolescents with recurrent functional abdominal pain. J Pediatr 113:820–825, 1988

    Google Scholar 

  6. Hyman PE, Napolitano JE, Diego A, Patel S, Flores AF, Grill BB, Reddy SN, Garvey TQ, Tomomasa T, et al: Antroduodenal manometry in the evaluation of chronic functional gastrointestinal symptoms. Pediatrics 86:39–44, 1990

    Google Scholar 

  7. Cucchiara S, Staiano A, Gobio-Casali L, Boccieri A, Paone FM: Value of the 24-hour intraoesophageal pH monitoring in children. Gut 31:129–133, 1990

    Google Scholar 

  8. Bolondi L, Bortolotti M, Santi V, Calletti T, Gaiani S, Labò G: Measurement of gastric emptying time by real-time ultrasonography. Gastroenterology 89:752–759, 1985

    Google Scholar 

  9. Van der Schee EJ, Smout AJPM, Grashuis JL: Application of running spectrum analysis to electrogastrographic signals recorded from dog and man.In Motility of the Digestive Tract. M Weinbeck (ed). New York, Raven Press, 1982, pp 241–250

    Google Scholar 

  10. Van der Schee EJ, Grashuis JL: Running spectrum analysis as an aid in the representation and interpretation of electrogastrographic signals. Med Biol Eng Comput 25:57–62, 1987

    Google Scholar 

  11. Cucchiara S, Riezzo G, Pezzolla F, Baldassarre M, Giorgio I, Auricchio S: Study of the electrical activity of the stomach in children with non-ulcer dyspepsia (NUD). Pediatr Res 27:530, 1990

    Google Scholar 

  12. Koch KL, Stern RM, Vasey M, Botti JJ, Creasy GW, Dwyer A: Gastric dysrhythmias and nausea of pregnancy. Dig Dis Sci 35:961–968, 1990

    Google Scholar 

  13. Cucchiara S, Bortolotti M, Colombo C, Boccieri A, De Stefano M, Vitiello G, Pagano A, Ronchi A, Auricchio S: Abnormalities of Gastrointestinal motility in children with nonulcer dypepsia and in children with gastroesophageal reflux disease. Dig Dis Sci 36:1066–1073, 1991

    Google Scholar 

  14. Read MW, Hoaghton LA: Physiology of gastric emptying and pathophysiology of gastroparesis. Gastroenterol Clin North Am 18:369–373, 1989

    Google Scholar 

  15. Geldof H, van der Schee EJ: Electrogastrography. Clinical applications. Scand J Gastroenterol 24(suppl 171):75–82, 1989

    Google Scholar 

  16. Szursewski JH: Electrical basis for gastrointestinal motility.In Physiology of the Gastrointestinal Tract, 2nd ed. LA Johnson (ed). New York, Raven Press, 1987, pp 383–422

    Google Scholar 

  17. Dubois A: Gastric dysrhythmias: Pathophysiologic and etiologic factors. Mayo Clin Proc 64:246–250, 1989

    Google Scholar 

  18. Abell TL, Malagelada JR: Electrogastrography. Current assessment and future perspectives. Dig Dis Sci 33:982–992, 1988

    Google Scholar 

  19. You CH, Lee KY, Chey WY, et al: Electrogastrographic study of patients with unexplained nausea, bloating and vomiting. Gastroenterology 79:311–314, 1980

    Google Scholar 

  20. Geldof H, van der Schee EJ, van Blankenstein M, Grashuis JL: Electrogastrographic study of gastric myoelectrical activity in patients with unexplained nausea and vomiting. Gut 27:799–808, 1986

    Google Scholar 

  21. Abell TL, Malagelada JR: Glucagon-evoked gastric dysrhythmias in humans shown by an improved electrogastrographic technique. Gastroenterology 88:932–940, 1985

    Google Scholar 

  22. Kim CH, Zinsmeister AR, Malagelada JR: Effect of gastric dysrhythmias on postcibal motor activity of the stomach. Dig Dis Sci 33:193–199, 1988

    Google Scholar 

  23. Kim CH, Hanson RB, Abell TL, Malagelada JR: Effect of inhibition of prostaglandin synthesis on epinephrine-induced gastroduodenal electromechanical changes in humans. Mayo Clin Proc 64:149–157, 1989

    Google Scholar 

  24. Sarna SK, Daniel EE: Threshold curves and refractoriness properties of gastric relaxation oscillators. Am J Physiol 226:749–755, 1974

    Google Scholar 

  25. Kim CH, Malagelada JR, Azpiroz F, Zinsmeister AR: Meal reduces sensitivity of the stomach to pharmacologically induced dysrhythmia. Dig Dis Sci 32:1027–1032, 1987

    Google Scholar 

  26. McCallum RW: Gastric emptying in gastroesophageal reflux and the therapeutic role of prokinetic agents. Gastroenterol Clin North Am 19:551–564, 1990

    Google Scholar 

  27. Koch KL, Stern RM, Stewart WR, Vasey MW: Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: Effect of long-term domperidone treatment. Am J Gastroenterol 84:1069–1075, 1989

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cucchiara, S., Minella, R., Riezzo, G. et al. Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia report of three cases. Digest Dis Sci 37, 1136–1140 (1992). https://doi.org/10.1007/BF01300300

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01300300

Key Words

Navigation