Journal
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume 41, Issue 4, Pages 360-367Publisher
WILEY-BLACKWELL
DOI: 10.1111/apt.13053
Keywords
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Funding
- Rouen University Hospital
- Region of Upper Normandy (AOI Jeunes Chercheurs)
- Charles Nicolle Foundation
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BackgroundPyloric pressure and compliance have never been investigated in health nor gastroparesis. AimWe hypothesised that pyloric pressure and/or compliance may be altered in gastroparesis. MethodsFasting pyloric pressure and compliance were investigated in 21 healthy volunteers (HV), 27 gastroparetic patients (GP) and 5 patients who had undergone oesophagectomy without pyloroplasty as positive controls. Under videofluoroscopic control, pyloric compliance and pressure were measured by the EndoFLIP technique. Gastric emptying half time (T-1/2) using C-13-octanoic acid breath test, as well as symptoms and quality of life (GIQLI score) were also monitored. ResultsMean fasting pyloric compliance was measured at 25.22.4mm(2)/mmHg in HV, and was lower both in GP (16.9 +/- 2.1mm(2)/mmHg; P<0.05) and patients with oesophagectomy (10.9 +/- 2.9mm(2)/mmHg; P<0.05). By contrast, fasting pyloric pressure was not different among groups. Fasting pyloric compliance and pressure correlated with T-1/2 in GP (R=-0.43; P=0.04). Fasting pyloric compliance, but not pressure, correlated with symptoms and GIQLI score. Pyloric dilation in 10 GP with low fasting pyloric compliance (<10mm(2)/mmHg) increased compliance from 7.4 +/- 0.4 to 20.1 +/- 4.9mm(2)/mmHg (P<0.01) and improved the GIQLI score from 72.5 +/- 5.5 to 89.3 +/- 6.1 (P=0.04). ConclusionThis prospective study assessed pyloric compliance for the first time, and showed that fasting pyloric compliance is decreased in gastroparetic patients and is associated with T-1/2, symptoms and quality of life. This suggests that pyloric compliance may be a new relevant metric in gastroparetic patients, and may be useful to target patients for pyloric dilation or botulinum toxin injection.
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