Gastric Dysrhythmia Syndrome refers to a group of symptoms including nausea, vomiting, abdominal pain, abdominal distension, and fullness caused by disordered or excessively rapid gastric motility. This condition often occurs after abdominal surgeries such as cholecystectomy, hiatal hernia repair, or pyloroplasty, as well as in cases of extensive autonomic nerve damage in grade III diabetes. Some studies suggest that an imbalance in the delicate ratio between excitatory neurotransmitters (such as acetylcholine, motilin, and gastrin) and inhibitory neurotransmitters (such as norepinephrine, dopamine, vasoactive intestinal peptide, and enkephalins) may lead to gastric dysrhythmia.

bubble_chart Clinical Manifestations

Patients may exhibit irregular pacesetter potentials (PP) or rapid rhythms, reaching up to 9 times per minute (normal range is 3-4 times per minute). In severe cases, ectopic rhythms may arise in the distal gastric antrum, causing retrograde propagation of PP to the proximal antrum, leading to severe vomiting or retching. The condition is significantly more common in women than in men. Clinical manifestations include intermittent episodes of nausea, vomiting, epigastric pain, and early satiety. A few patients may experience abdominal distension and fullness due to gastric retention. Gastric electromyography can record disturbances in gastric electrical rhythm. Diagnosis requires the exclusion of organic diseases.

bubble_chart Treatment Measures

Treatment options include chlorpromazine and anticholinergic drugs, but they are often ineffective. It has been reported that domperidone (Motilium) 10–20 mg each time, 3–4 times daily, often has some effect. Cisapride can also be tried at 5–10 mg per dose, 2–3 times daily, both taken before meals. For those who do not respond, distal hemigastrectomy and gastrojejunostomy may be performed.