Effects Of Test Meal On Multi-Channel Electrogastrography And Autonomic Nervous System Function In Patients With Gastroesophageal Reflux Diseases

The aims of this study were to utilize multi-channel electrogastrography (MEGG) and power spectra analysis of Heart Rate Variability (HRV) to investigate the effects of test meal on MEGG and autonomic nervous system (ANS) function in patients with gastroesophageal reflux disease (GERD). Methods:  Sixteen patients with the diagnosis of GERD were enrolled in this study (11 M, 5 F, mean age: 47 yrs) and 16 healthy subjects (HS) matched for age and gender were recruited as control (11 M, 5 F, mean age: 47 yrs). MEGG was recorded simultaneously with the electrocardiogram (ECG) recording for 30 min in the fasting state and 60 min after a standard test meal (450 Kcal). MEGG parameters included dominant frequency (DF), dominant power (DP), the normal percentage of 2–4 cpm gastric slow waves (%N) and the percentage of slow wave coupling (%SWC). ANS parameters included sympathovagal balance LF/HF Ratio, mainly sympathetic activity LF and vagal activity HF. Results:  (1) Compared with fasting state, test meal significantly increased the DF but decreased the %N and %SWC in both GERD patients and HS in the 1st 30 min and 2nd 30 min fed state (P < 0.05). DP was not significantly altered by test meal in both groups in fed state. However, there is no significant difference between 1st 30 min and 2nd 30 min fed state for DF, %N and %SWC. 2) Compared with fasting state, test meal significantly increased the LF/HF ratio and LF but decreased the HF in both groups in the 1st 30 min after meal (P < 0.05), however, the increase of LF/HF ratio and LF but decrease of HF were still present in HS whereas absent in patients with GERD in the 2nd 30 min fed state. There is no significant difference between 1st 30 min and 2nd 30 min fed state for those ANS parameters. (3) There was no significant difference between GERD patients and HS in any of those MEGG and ANS parameters neither in fasting state nor in fed state. (4) There was no significant correlation between MEGG parameters and ANS parameters neither in fasting state nor in fed state in both groups. Conclusions:  Both patients with GERD and HS may have similar response to test meal in MEGG test. GERD patients could not maintain the response to test meal longer in ANS test suggests that GERD patients may have impaired ANS regulation to test meal.