Gallbladder and gastric motility in patients with idiopathic slow-transit constipation.

OBJECTIVE: Idiopathic slow-transit constipation (STC) has been suggested to be a pangastrointestinal motility disorder. We investigated scintigraphically whether motility in the gallbladder and stomach was impaired in slow-transit constipation. METHODS: Twenty-four patients with STC were studied. Colon transit time, gallbladder motility, and solid-phase gastric emptying were measured by scintigraphy. RESULTS: Gallbladder dysmotility was observed in 8 of 18 (44.4%) patients. Mean gallbladder ejection fraction was 41.6 +/- 13.6% (range, 16.3-67.0%). Gastric emptying was delayed in 9 of 18 (50%) patients. Mean solid-phase gastric half-emptying time was 75 minutes. STC may be associated with impaired function of other gastrointestinal organs. Approximately half of patients with STC presented gallbladder or gastric dysmotility. CONCLUSION: STC may not be a pure colonic abnormality; it may be a component of a pangastrointestinal tract motility disorder involving several organs.

Acustimulation of the Neiguan point during gastroscopy: its effects on nausea and retching.

BACKGROUND/AIMS: Gastroscopic procedure causes nausea and retching in many patients. Recently, alternative methods have been employed in an effort to reduce these symptoms. The Neiguan point (P6) is an acupuncture point that has been used for approximately 3,000 years to overcome gastric symptoms including nausea and retching. The aim of this study was to investigate the effects of the stimulation of the P6 acupoint on swallowing, nausea and retching during the gastroscopic procedure. METHODS: Three hundred and twenty-seven patients who visited the gastroenterology unit for dyspeptic complaints were included in the study. A portable transcutaneous electrical nerve stimulation device (Reliefband; Maven Lab, Yuba City, CA) was used for acustimulation. The device was attached 15 minutes before the endoscopic procedure and no sedation was applied. The device was turned on in 78 patients (Group 1). The device was attached but not turned on in another 79 patients (Group 2). In Group 3, the device was attached to the Sham point (n: 79). In Group 4 the procedure was performed with no attachments (n: 77). Fourteen patients dropped out of the study because esophagogastroduodenoscopy could not be completed due to patient intolerance or to obstruction in the upper gastrointestinal tract. After the procedure, each patient's opinion about the severity of nausea and retching was measured on a visual analogue scale. Distress in swallowing and the impression of the endoscopist during the procedure were scored from 1 to 4. Patients were queried regarding their willingness to undergo re-endoscopy. RESULTS: Groups were compared regarding their distress in swallowing the endoscope, nausea and retching, the impression of the endoscopist during the procedure and their acceptance of re-endoscopy. Groups 1, 2, 3 and 4 were compared using the chi-square test, and no significant difference was observed between the groups (p>0.05). CONCLUSIONS: Acustimulation of the Neiguan (P6) acupoint does not relieve patients of the nausea observed during gastroscopy, and its application does not facilitate the procedure.