Distal gastric antrum produces ectopic rhythm

Introduction Gastric Dysrhythmia syndrome refers to a group of syndromes of nausea, vomiting, abdominal pain, and bloating caused by disordered or too fast gastric motility rhythm. Patients may have irregular pace potential (ppesetter potential, pp) release or rapid rhythm, even in the distal antrum to produce ectopic rhythm, pp reverse propagation to the proximal gastric antrum, and there is hyperemesis or retching. A group of syndromes caused by nausea, vomiting, abdominal pain, and bloating due to disordered or too fast gastric motility rhythm. Intrinsic occurs mostly after abdominal surgery, such as cholecystectomy, esophageal hiatal hernia repair or pyloric angioplasty, as well as extensive damage to severe diabetic autonomic nerves.

Cause

Causes of ectopic rhythm in the distal antrum:

A group of syndromes caused by nausea, vomiting, abdominal pain, and bloating due to disordered or too fast gastric motility rhythm. Intrinsic occurs mostly after abdominal surgery, such as cholecystectomy, esophageal hiatal hernia repair or pyloric angioplasty, as well as extensive damage to severe diabetic autonomic nerves. Other studies suggest that fine-scale imbalance between excitatory neurotransmitters (such as acetylcholine, motilin and gastrin) and inhibitory neurotransmitters (such as norepinephrine, dopamine, etc.) can lead to gastric rhythm disorders.

an examination

Related inspection

Gastric ultrasound examination of electromyography

Examination of the ectopic rhythm of the distal antrum:

Patients may have irregular paced potential (ppesetter potential, pp) or fast rhythm, up to 9 times per minute (normal people 3 to 4 times per minute), even in the distal antrum to produce ectopic rhythm to make pp reverse Spread to the proximal gastric antrum, and there is severe vomiting or retching. Women have significantly more morbidity than men. Clinical manifestations include intermittent nausea, vomiting, upper abdominal pain, early satiety, and a small amount of abdominal distension due to gastric retention. Gastric electromyography can record gastric myoelectric rhythm disorders. Diagnosis is still necessary to exclude organic diseases.

Differential diagnosis

1, gastric ulcer: ulcer disease is a common chronic systemic disease, divided into gastric ulcer and duodenal ulcer, also known as peptic ulcer. It is called peptic ulcer because it was previously thought that gastric ulcer and duodenal ulcer were formed by gastric acid and pepsin digestion of the mucous membrane itself. In fact, gastric acid and pepsin are only one of the main causes of ulcer formation. There are other reasons for ulcer disease. Because of the many similarities between the etiology and clinical symptoms of gastric and duodenal ulcers, it is sometimes difficult for doctors to distinguish between gastric ulcers and duodenal ulcers. Therefore, they are often diagnosed as peptic ulcers, or stomach and duodenal ulcers. . If the ulcer is clear in the stomach or duodenum, it can be directly diagnosed as a gastric ulcer or duodenal ulcer.

2, gastritis: gastritis is a general term for inflammation of the gastric mucosa. Common diseases can be divided into acute and chronic. Acute gastritis is common in both simple and erosive. The former manifested as upper abdominal discomfort, pain, anorexia and nausea, vomiting; the latter is the main manifestation of gastrointestinal bleeding, hematemesis and black feces. Chronic gastritis can usually be divided into superficial gastritis, atrophic gastritis and hypertrophic gastritis. The course of chronic gastritis is prolonged, and most of them have no obvious symptoms and signs. Generally, they only see symptoms of dyspepsia such as fullness after meals, pantothenic acid, hernia, and irregular abdominal pain. The diagnosis depends mainly on gastroscopy and gastric mucosal biopsy. The disease is common in adults, many causes can stimulate the stomach, such as improper diet, viral and bacterial infections, drug stimulation, etc. may cause the disease.

3, gastric perforation: gastric perforation is one of the most serious complications of ulcer patients. The patient's gastric perforation is mainly caused by overeating. Overeating can cause an increase in gastric acid and pepsin, and it is easy to induce gastric perforation.

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