Daniel A Carson1, Sameer Bhat1, Tommy C L Hayes1, Armen A Gharibans1,2, Christopher N Andrews3, Gregory O'Grady1,2, Chris Varghese4. 1. Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand. 2. Auckland Bioengineering Institute, The University of Auckland, Auckland, 1010, New Zealand. 3. Department of Medicine, University of Calgary, Calgary, Canada. 4. Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand. cvar706@aucklanduni.ac.nz.
Abstract
BACKGROUND: Functional nausea and vomiting syndromes and gastroparesis, collectively grouped as nausea and vomiting syndromes (NVS), are overlapping conditions with incompletely understood pathophysiology. Gastric slow wave abnormalities are thought to contribute. AIMS: This study aimed to systematically review and meta-analyze the prevalence of slow wave abnormalities measured by electrogastrography (EGG) in patients with NVS. METHODS: MEDLINE, EMBASE, EMBASE classic, and CENTRAL databases were systematically searched for articles using EGG in adults (≥ 18 years) with NVS. EGG metrics of interest were percentage time in bradygastria, normogastria, and tachygastria as well as dominant frequency and dominant power. Outcomes were also compared with functional dyspepsia (FD), gastroesophageal reflux disease (GORD), and control cohorts. RESULTS: Seven hundred and sixty NVS patients and 308 controls were included from 24 studies. Overall, 64% of patients had EGG abnormalities. Average percent time in normogastria was low during fasting (50%; 95% CI 40-63%) and fed (53%; 95% CI 41-68%) states in patients, with substantial periods in fasting bradygastria (34.1%; 95% CI 25-47%) and postprandial tachygastria (21%; 95% CI 17-26%). Across gastric disorders, pooling of 84 studies showed a comparably high prevalence of EGG abnormalities in NVS (24 studies; n = 760) and GORD (13 studies; n = 427), compared to FD (47 studies; n = 1751) and controls (45 studies; n = 1027). CONCLUSIONS: Frequency-based gastric slow wave abnormalities are prominent in NVS. The strength and consistency of these associations across many studies suggests that gastric dysrhythmia may be an important factor in NVS, motivating the development of more reliable methods for their clinical assessment.
BACKGROUND: Functional nausea and vomiting syndromes and gastroparesis, collectively grouped as nausea and vomiting syndromes (NVS), are overlapping conditions with incompletely understood pathophysiology. Gastric slow wave abnormalities are thought to contribute. AIMS: This study aimed to systematically review and meta-analyze the prevalence of slow wave abnormalities measured by electrogastrography (EGG) in patients with NVS. METHODS: MEDLINE, EMBASE, EMBASE classic, and CENTRAL databases were systematically searched for articles using EGG in adults (≥ 18 years) with NVS. EGG metrics of interest were percentage time in bradygastria, normogastria, and tachygastria as well as dominant frequency and dominant power. Outcomes were also compared with functional dyspepsia (FD), gastroesophageal reflux disease (GORD), and control cohorts. RESULTS: Seven hundred and sixty NVS patients and 308 controls were included from 24 studies. Overall, 64% of patients had EGG abnormalities. Average percent time in normogastria was low during fasting (50%; 95% CI 40-63%) and fed (53%; 95% CI 41-68%) states in patients, with substantial periods in fasting bradygastria (34.1%; 95% CI 25-47%) and postprandial tachygastria (21%; 95% CI 17-26%). Across gastric disorders, pooling of 84 studies showed a comparably high prevalence of EGG abnormalities in NVS (24 studies; n = 760) and GORD (13 studies; n = 427), compared to FD (47 studies; n = 1751) and controls (45 studies; n = 1027). CONCLUSIONS: Frequency-based gastric slow wave abnormalities are prominent in NVS. The strength and consistency of these associations across many studies suggests that gastric dysrhythmia may be an important factor in NVS, motivating the development of more reliable methods for their clinical assessment.
Authors: Gregory O'Grady; Timothy R Angeli; Peng Du; Chris Lahr; Wim J E P Lammers; John A Windsor; Thomas L Abell; Gianrico Farrugia; Andrew J Pullan; Leo K Cheng Journal: Gastroenterology Date: 2012-05-27 Impact factor: 22.682
Authors: Gregory O'Grady; Tim H-H Wang; Peng Du; Tim Angeli; Wim J E P Lammers; Leo K Cheng Journal: Clin Exp Pharmacol Physiol Date: 2014-10 Impact factor: 2.557
Authors: Timothy R Angeli; Leo K Cheng; Peng Du; Tim Hsu-Han Wang; Cheryl E Bernard; Maria-Giuliana Vannucchi; Maria Simonetta Faussone-Pellegrini; Christopher Lahr; Ryash Vather; John A Windsor; Gianrico Farrugia; Thomas L Abell; Gregory O'Grady Journal: Gastroenterology Date: 2015-04-08 Impact factor: 22.682
Authors: D F Stroup; J A Berlin; S C Morton; I Olkin; G D Williamson; D Rennie; D Moher; B J Becker; T A Sipe; S B Thacker Journal: JAMA Date: 2000-04-19 Impact factor: 56.272
Authors: Madhusudan Grover; Gianrico Farrugia; Matthew S Lurken; Cheryl E Bernard; Maria Simonetta Faussone-Pellegrini; Thomas C Smyrk; Henry P Parkman; Thomas L Abell; William J Snape; William L Hasler; Aynur Ünalp-Arida; Linda Nguyen; Kenneth L Koch; Jorges Calles; Linda Lee; James Tonascia; Frank A Hamilton; Pankaj J Pasricha Journal: Gastroenterology Date: 2011-02-04 Impact factor: 22.682
Authors: Penny F Whiting; Anne W S Rutjes; Marie E Westwood; Susan Mallett; Jonathan J Deeks; Johannes B Reitsma; Mariska M G Leeflang; Jonathan A C Sterne; Patrick M M Bossuyt Journal: Ann Intern Med Date: 2011-10-18 Impact factor: 25.391
Authors: Roberta Sclocco; Harrison Fisher; Rowan Staley; Kyungsun Han; April Mendez; Andrew Bolender; Jaume Coll-Font; Norman W Kettner; Christopher Nguyen; Braden Kuo; Vitaly Napadow Journal: Neurogastroenterol Motil Date: 2022-05-13 Impact factor: 3.960