• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.769-778
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• 2007

Background & Object : Postprandial epigastric fullness is one of common symptoms in functional dyspepsia, but its pathophysiological mechanism has still been unknown. In this study, its association between postprandial epigastric fullness and pyloric valve disturbance was studied through analysis of bowel sounds and electrogastrography. Methods : Bowel sounds and electrogastrography were recorded together for fasting 15 min and postprandial 40 min. Parameters of bowel soundincluding motility index, sound to sound interval, standard deviation of sound to sound interval, sounds per minute, % of bowel sound, sound length, intensity, dominant frequency of sounds, and postprandial / fasting ratio of dominant frequency of sounds were analyzed with a specialized program. By electrogastrography, regularity of slow waves and power ratio were obtained. Results : Significances of bowel sounds appeared in motility index (p=0.046), dominant frequency of fasting (p=0.048), postprandial (p=0.003), and the ratio of postprandial/fasting (p=0.000); those of EGG parameters were shown in postprandial regularity of slow waves (p=0.006) and power ratio (p=0.011). Conclusion : Pyloric valve disturbance was a cause of postprandial epigastric fullness in patients with functional dyspepsia. Analysis of bowel sound might be useful in diagnosing its existence.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.666-674
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• 2008

Objectives : The aim of this study was to evaluate gastrointestinal parasympathetic nerve activation and pyloric valve function in patients with functional dyspepsia through analysis of bowel sounds and to investigate clinical characteristics associated with the parameters of bowel sounds. Method : We surveyed clinical characteristics of patients by using a questionnaire about functional dyspepsia. Bowel sounds were recorded for 15 minutes during fasting state and for 40 minutes during postprandial state. We then classified the patients into 3 groups by abnormal states of bowel sounds, specifically by the percentage of B.S. and dominenet frequency, and studied clinical characteristics in each group. Results : Among the 182 subjects, patients who had low activity of parasympathetic nerve were 25.8% and showed a tendency of female-dominant, family history and more frequent abdominal pain. Those who had pyloric valve disturbance were 24.1% and showed no tendency by sex distribution, family history and complained of indigestion sensation. Patients who had both disorders were 10.9%, and their clinical characteristics were non-specific. Conclusion : Analysis of bowel sounds may be useful in evaluating pathophysiological factors of functional dyspepsia.

• The Journal of Internal Korean Medicine
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• v.30 no.3
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• pp.604-611
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• 2009

Objectives : The aim of this study was to investigate the relationship between headache and gastric dysmotility in patients with functional dyspepsia by using electrogastrogram and bowel sounds analysis. Methods : 127 patients(male 40, female 87) with functional dyspepsia were enrolled. By using inquiry and the questionnaire, we examined whether each patient had headache and abdominal pain. All patients were divided into 4 groups according to the above symptoms. Gastric motility was measured during the fasting-postprandial state by using electrogastrogram and bowel sounds analysis. Results : 33 patients complained of headache. There was a significant difference between headache patients and non-headache patients in gastric arrhythmia of the fasting state. Moreover, in headache patients without abdominal pain, postprandial improvement of gastric arrhythmia was poorer than the other groups. So, headache patients without abnormal pain had more severe gastric myoelectrical rhythm disorder than headache patients with abdominal pain. Conclusion : Headache could be one of symptoms induced by gastric dysmotility in patients with functional dyspepsia. Especially, headache in functional dyspepsia was related to gastric arrhythmia.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.60 no.4
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• pp.877-879
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• 2011

Bowel sounds (BS) are produced by the movement of the intestinal contents in the lumen of the gastro-intestinal tract during peristalsis and thus, it can be used clinically as useful indicators of bowel motility. We devised an estimation algorithm of bowel motility based on the regression modeling of the jitter and shimmer of BS signals measured by auscultation. Ten healthy males ($23.5\pm2.1$ years) were examined. Consequently, the correlation coefficient, coefficient of determination and standard error between the colon transit times (CTT) measured by a conventional radiograph and the values estimated by our algorithm were 0.98, 0.96 and 2.86, respectively. Also, through k-fold cross validation, the average value of the absolute differences between them was $5.0\pm2.5$ hours. This method could be used as a complementary tool for the non-invasive measurement of bowel motility.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.276-283
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• 2015

Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.191-199
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• 2009

Objectives : The aim of this study was to evaluate the therapeutic effect of acupuncture and herbal medicine in patients who had hvpoactivity of the gastric vagus nerve and pyloric valve disturbance simultaneously with function dyspepsia by bowel sounds analysis. Methods : Bowel sounds of 10 patients (male 1, female 9) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed before and after treatment. Hypoactivity of the gastric vagus nerve was considered if % BS was <6%. and pyloric valve disturbance was accepted if DF ratio (e.g.. postprandial DF/fasting DF) was <1. Electroacupuncture at Zusanli (ST36, 3Hz, 30 minutes) and manual acupuncture at other meridian points were applied daily for 2 weeks. Herbal medicine, Pyengwi-san. was administered to all patients (100cc, 3 times/day). Results : DF ratio significantly increased from $0.93\pm0.06$ to $1.06\pm0.04$ after treatment for 2 weeks (p=0.005). 9 of 10 patients were improved to DF ratio>1. %BS also increased from $2.97\pm1.17%$ to $4.49\pm4.27%$. not significantly. 3 patients showed a remarkable elevation, and their %BS reached >6% of normal value. Conclusions : Combined effect of electroacupuncture at Zusanli (ST36), manual acupuncture. and Pyengwi-san was shown effective in the improvement of pyloric valve disturbance more than hypoactivity of gastric vagus nerve on patients with functional dyspepsia.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.621-628
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• 2008

Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.