ANTRODUODENAL MANOMETRY - 24-HOUR AMBULATORY MONITORING VERSUS SHORT-TERM STATIONARY MANOMETRY IN PATIENTS WITH FUNCTIONAL DYSPEPSIA

Objectives: To examine the interdigestive and postprandial antroduodenal motility patterns of patients with functional dyspepsia using prolonged ambulatory antroduodenal manometry and to compare these findings with conventional stationary manometry. Methods: Prolonged ambulatory and short-term stationary antroduodenal manometry were performed in 10 patients with functional dyspepsia and in 10 healthy volunteers (controls). Results: During stationary manometry only a few interdigestive motor complex (MMC) cycles were recorded. Using the ambulatory technique, fewer MMC cycles were observed in patients than in controls (2.2+/-0.63 and 4.1+/-0.54, respectively; P=0.030). During phase II of the MMC, both techniques showed a higher antral motility index in patients (P=0.017 and P=0.049 for stationary and ambulatory manometry, respectively). The postprandial antral motility index was similar for patients and controls using stationary manometry. With the ambulatory technique, the antral motility index 1-1.5 h after breakfast was lower in patients than in controls (P=0.020). Both techniques showed that the patients had a higher duodenal motility index after dinner and after breakfast (P<0.05). Both techniques revealed more burst activity in patients than in controls (stationary: 10.7 versus 1.8% of the time; ambulatory: 1.7 versus 0.2% of the time; P=0.004 and P=0.051, respectively). Using a 10-min window period before the onset of symptoms, seven symptom episodes (33.3%) were found to be related to burst activity and retrograde or non-propagated phase III activity. Conclusions: Ambulatory manometry is superior to stationary manometry for evaluating patients with functional dyspepsia, because patients can be studied for a prolonged period (allowing adequate evaluation of interdigestive abnormalities) and under physiological conditions. Prolonged monitoring also allows assessment of the relationship between symptoms and motor abnormalities.