Bodysurface gastric mapping (BSGM) will be used to assess gastric neuromuscular function in healthy controls and patients with medical refractory gastroesophageal reflux disease (GERD). Participants will undergo BSGM for 4-hours in addition to high resolution manometry (HRM), pH-impedance monitoring, and gastric emptying breath test.
This is a clinical trial of a non-invasive BSGM medical device (Gastric Alimetry) in patients with medical refractory GORD and healthy controls to determine the differences in gastric electrical activity, and correlate with adjacent measurements of gastro-esophageal function. Patients referred to the Functional Gut Clinic for standard care investigation of GORD with HRM and pH-impedance monitoring will be recruited. Healthy volunteers will be recruited via advertisement. All patients and healthy volunteers will undergo BSGM at the research site, which lasts around 4.5 hours. After a 0.5 hour baseline, subjects will undergo HRM and pH-impedance monitoring concomitantly. A test meal of porridge with C13 labelled octanoic acid will be consumed with BSGM and breath samples recorded for 4.0 hours after meal completion. The HRM catheter will be removed after 1.0 hour from finishing the test meal whist the pH-impedance monitoring will continue for the remainder of the site visit and for the remainder of the 24-hour study period whilst the subject is at home to quantify reflux.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
60
64-channel electrode array placed on the outer abdomen
The Functional Gut Clinic
Manchester, Greater Manchester, United Kingdom
RECRUITINGDifference in BSGM parameters between GORD and healthy controls
Gastric Alimetry Rhythm Index (Normal \>0.25)
Time frame: 24-hours
Difference in BSGM parameters between GORD and healthy controls
Prinicpal Gastric Frequency (Normal: 2.65-3.35cpm)
Time frame: 24-hours
Difference in BSGM parameters between GORD and healthy controls
Fed:Fasted Amplitude ratio (Normal: \>1.08)
Time frame: 24-hours
Difference in BSGM parameters between GORD and healthy controls
Average Amplitude (Normal: 20-70 microvolts)
Time frame: 24-hours
Difference in BSGM parameters between GORD and healthy controls
% of retrograde activity
Time frame: 24-hours
Normal reference ranges for gastric emptying and BSGM
T lag and T 1/2 time (minutes)
Time frame: 24-hours
Correlate reflux event frequency with Gastric Alimetry Rhythm Index
Frequency of reflux events with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate reflux event frequency with Prinicpal Gastric Frequency (cpm)
Frequency of reflux events with Prinicpal Gastric Frequency (cpm)
Time frame: 24-hours
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Correlate reflux event frequency with Fed:Fasted Amplitude ratio
Frequency of reflux events with Fed:Fasted Amplitude ratio
Time frame: 24-hours
Correlate reflux event frequency with Average Amplitude
Frequency of reflux events with Average Amplitude (microvolts)
Time frame: 24-hours
Correlate reflux event frequency with % of retrograde activity
Frequency of reflux events with % of retrograde activity
Time frame: 24-hours
Correlate symptom severity with BSGM parameters
Real time discrete (vomiting, belching, reflux counts) and continuous (Nausea, bloating, upper gut pain, heartburn, stomach burn and excessive fullness) gastrointestinal symptom scores at both pre- and post-prandial time periods determined by a series of multiple 10-point symptom severity scales integrated within the validated Gastric Alimetry iOS Application with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate quality of life with BSGM parameters
Total symptom burden scores according to the PAGI-QOL with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate the results of gastric emptying with BSGM parameters
T lag and T 1/2 (minutes) with ith Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate the results of oesophageal manometry with BSGM parameters
Distal contractile integral (mmHg.s.cm) with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate the results of oesophageal manometry with Gastric Alimetry Rhythm Index
Integrated relaxation pressure (mmHg) with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate the results of oesophageal manometry with Prinicpal Gastric Frequency
Integrated relaxation pressure (mmHg) with Prinicpal Gastric Frequency
Time frame: 24-hours
Correlate the results of oesophageal manometry with Prinicpal Gastric Frequency
Integrated relaxation pressure (mmHg) with % of retrograde activity
Time frame: 24-hours
Correlate the results of oesophageal manometry with Gastric Alimetry Rhythm Index
Frequency of transient lower oesophageal sphincter relaxation (TLOSRs) with Gastric Alimetry Rhythm Index
Time frame: 24-hours
Correlate the results of oesophageal manometry with Gastric Alimetry Rhythm Index
Frequency of transient lower oesophageal sphincter relaxation (TLOSRs) with Prinicpal Gastric Frequency
Time frame: 24-hours
Correlate the results of oesophageal manometry with % of retrograde activity
Frequency of transient lower oesophageal sphincter relaxation (TLOSRs) with % of retrograde activity
Time frame: 24-hours
Correlate the results of hydrogen and methane breath testing with Gastric Alimetry Rhythm Index
Total gas production (AUC ppm) with Gastric Alimetry Rhythm Index
Time frame: 7 days