Gastric emptying and antral myoelectrical activity in chronic alcoholics with dyspepsia

BACKGROUND/AIMS: Chronic alcoholism is known to effect gastric motor activity. An association between gastric motility disorders and abnormal myoelectrical activity has been observed in various gastrointestinal and extra-intestinal diseases. The aim of this study was to investigate the effect of chronic alcoholism on gastric emptying and antral myoelectrical activity. METHODOLOGY: Electrogastrography (EGG) was performed on 20 chronic alcoholics with chronic dyspepsia using a pair of electrodes sonographically placed on the skin overlying the gastric antrum. After an overnight fast, patients were tested over a period of one hour in the a) fasting and b) fed state, after ingestion of a 370 kcal liquid-solid test meal. The following EGG parameters were determined: dominant frequency (DF (cpm); DF (%) in the normal range (2-4 cpm); bradygastria (<2 cpm); tachygastria (4-10 cpm); dominant frequency instability coefficient (DFIC), and postprandial to fasting power ratio (PR). The data were correlated with results obtained from 20 controls matched for age and sex. In 18 alcoholics, the EGG data were compared to the percentage of radionuclides (liquid phase labeled with 99m Tc colloid) remaining in the stomach after 60 minutes (%) (gamma camera system). Moreover, for the alcoholics, various parameters such as ethanol consumption, and gastrointestinal symptoms were determined and related to EGG values and scintigraphy. RESULTS: About 50% of the alcoholics showed delayed gastric emptying compared to normal values previously reported (t 60 values: >68%). In opposite to scintigraphy, the alcoholics did not exhibit abnormalities in antral myoelectrical activity. They had significantly decreased bradygastria measures compared to controls (p<0.05). The scintigraphic t 60 values did not correlate either with EGG values or with dyspepsia and clinical parameters. EGG values did not correlate with dyspepsia. However, increased preprandial DF was significantly correlated with ethanol consumption. CONCLUSIONS: Chronic alcoholism induces a disturbance of gastric emptying, probably resulting from toxic damage of the gastrointestinal smooth muscles. Disturbances in antral myoelectrical activity were not found.