Characterization of gastric dysfunction after fundoplication using body surface gastric mapping

Area of Science:

• Gastroenterology
• Medical Devices
• Physiology

Background:

• Persistent adverse gastric symptoms affect up to 20% of patients post-fundoplication for GERD.
• These symptoms cause significant morbidity and necessitate revisional surgeries.
• A lack of noninvasive methods to assess post-fundoplication symptom mechanisms exists.

Purpose of the Study:

• To investigate gastric myoelectrical abnormalities and symptoms in patients post-fundoplication.
• To utilize a novel noninvasive body surface gastric mapping (BSGM) device for this assessment.

Main Methods:

• Recruited 16 patients with persistent gastroduodenal symptoms post-fundoplication and 16 matched controls.
• Employed BSGM using the Gastric Alimetry system, featuring a 64-channel array, symptom-logging app, and wearable reader.

Main Results:

• 37.5% of patients (6/16) exhibited significant spectral abnormalities in gastric myoelectrical activity (instability, high frequency, or amplitude).
• Patients with abnormalities reported higher symptom severity scores (P=.024).
• 43.8% (7/16) showed BSGM results suggesting gut-brain axis involvement without myoelectrical dysfunction; symptom severity correlated with specific BSGM metrics.

Conclusions:

• A substantial proportion of patients with persistent post-fundoplication symptoms demonstrate abnormal gastric function via BSGM.
• These findings correlate abnormal gastric function with symptom severity.
• The study advances understanding of post-fundoplication disorders, potentially guiding diagnosis and treatment decisions.