Gastric Myoelectric Activity Changes Of Gastroesophageal Reflux Disease And Functional Heartburn

Object:To study gastric myoelectric activity of patients with gastroesophageal reflux disease and functional heartburn;To investigate the relationship between psychological status and gastroesophageal reflux disease as well as functional heartburn.Method : Fasting and postprandial EGGs of 64 gastroesophageal reflux disease(GERD)paitents,24 functional heartburn(FH) patients and 24 healthy volunteers were recorded,to record the changes of gastric myoelectric activity of the patients in each group, and compare the difference of gastric electrical parameter;According to the results of gastroscope or 24 h esophageal PH,dividing the gastroesophageal reflux disease patiens into reflux esophagitis(RE) and non-erosive reflux disease(NERD),to compare the difference of gastric electrical parameter between two group,and compare the difference of gastric electrical parameter of RE,NERD and FH group patients.Symptoms of FH and GERD patients were assessed and compared with reflux disease questionnaire(RDQ).FH and GERD groups were asessed and compared with Zung self-rating depression scale(SDS) and Zung anxiety and self-rating scale(SAS),and calculated and compared incidence of depression and anxiety of two groups;To calculate and compare SDS scores and SAS scores of RE and NERD groups,as the same time,calculate the incidence of depression and anxiety of two groups,and compare the SDS scores and SAS scores of RE,NERD and FH groups.Results: 1.GERD patients had lower dominant frequency(DF), power ratio(PR), postprandial dominant power(DP) compared with FH patients and healthy patients(P<0.01), higher fasting dominant power compared with healthy patients, and lower with FH patients(P>0.05), postprandial dominant power were not significant arised(P>0.05). 2. FH patients’ DF, PR, fasting dominant power,postprandial dominant power displayed similar, all in normal range, compared to healthy patients(P>0.05), the patients had higher postprandial dominant power(P<0.01), compare to fasting dominant power. 3. RE patients and NERD patients had lower DF, PR, postprandial dominant power compared with FH patients and healthy patients(P<0.01). While, RE patients and NERD patients had lower fasting dominant power compared with healthy patients(P<0.01), but no significant difference compared with FH patients(P>0.05). RE patients had lower fasting dominant power, PR compared with NERD patients(P<0.01), but no significant difference on DF and postprandial dominant power(P>0.05), whereas RE patients displayed similar dominant power in fasting and postprandial(P>0.05), but NERD patients displayed difference significant dominant power in fasting and postprandial(P<0.01). 4. GERD patients, FH patients, healthy patients’ percentage of normal slow wave(N%), irrespective of fasting(54.60±11.57)%,(74.29±9.76)%, and( 84.31±5.22)%, of post-prandial(70.75±10.98)%,(87.83±9.07) % and(94.35±4.81)% recording, GERD patients’ percentage of normal slow wave had diminished, compared to FH patients, and two groups had difference significant, compared to healthy patients(P<0.01). RE patients and NERD patients’ percentage of normal slow wave,irrespective of fasting(50.24±11.68)%,(60.21±8.82)%,of post-prandial(70.67±8.38)%,(70.86±13.79)% recording, RE patients had lower fasting percentage of normal slow wave compared with NERD patients(P<0.01), no significant postprandial percentage of normal slow wave compared with NERD patients(P>0.05). All in all, percentage of normal slow wave were significant arised in postprandial, gastric electrical rhythm can be improved obviously in postprandial. 5. GERD patients and FH patients with anxiety scores were(49.20±8.94),(53.63±4.79) points, depression scores were(50.23±9.08),(55.54±2.98) points, respectively, two groups had significant difference(P<0.01). 6. FH patients, NERD patients and RE patients with anxiety scores were(53.63±4.79),(52.89±7.76),(46.33±8.84) points, depression scores were(55.54±2.98),(55.04±6.40),(46.50±9.13) points, respectively, three groups had significant difference(P<0.01). 7.GERD patients and FH patients with incidence ofanxiety were 45.3%, 75%, incidence of depression were 40.6%, 83.3%, respectively, two groups had significant difference(P<0.01). Among NERD patients and RE patients with incidence of anxiety were 60.7%,33.3%, incidence of depression were 64.3%, 22.2%, NERD patients had higher incidence of depression and anxiety compared with RE patients(P<0.01). 8. GERD patients with RDQ scores was(18.84±6.54) points, FH patients was(5.79±1.10) points, two groups had significant difference(P<0.01).Conclusions 1. The dominant frequency and power ratio were reduced in GERD patients, suggesting that the lack of gastric motility. 2.Gastric electrical rhythm disorder in GERD patients, and RE patients more than obvious in NERD patients, dysrhythmia can be improved obviously in postprandial. 3.FH patients with normal gastric myoelectric activity, while NERD patients with gastric dysrhythmias, can help in the identification of non erosive reflux disease and functional heartburn. 4.GERD patients with anxiety depression state, and different subtypes of anxiety incidence was different, of which NERD patients are more easily complicated with anxiety and depression. 5.Symptoms and metal factors of impact each other on its pathogenesis of GERD. 6.FH patients are more likely to complicated with psychological disorders than patients with GERD. 7.RDQ is a suitable,easily handled method in initial screening tests of GERD.