Further classification of dysmotility-like dyspepsia by interdigestive gastroduodenal manometry and plasma motilin level.

Abstract

To investigate interdigestive gastroduodenal motility with an infused catheter and measure plasma motilin levels in eight normal individuals and 18 patients with dysmotility-like dyspepsia. All normal individuals had normal gastroduodenal interdigestive migrating complexes. Patients with dysmotility-like dyspepsia were classified into three subgroups on the basis of gastric antral motility: 1) seven patients with normal interdigestive migrating complexes, 2) five patients without interdigestive migrating complexes and with gastric phase II predominant over phase I, and 3) six patients without interdigestive migrating complexes and with phase I predominance. The maximum and mean plasma motilin levels were significantly different in normal individuals from those in subgroup 3 (Kruskal-Wallis test, p < 0.05). Dysmotility-like dyspepsia appears to be a heterogeneous condition. Abnormal motilin secretion may cause dysmotility in subgroup 3, but dyspepsia in subgroup 1 and the absence of interdigestive migrating complexes in subgroup 2 could not be explained only on this basis.