A magnetic resonance imaging study of gastric motor function in patients with dyspepsia associated with Ehlers‐Danlos Syndrome‐Hypermobility Type: A feasibility study

Background The clinical use of Magnetic Resonance Imaging ( MRI ) for investigating gastric motor function in dyspepsia is limited, largely due to protocol complexity, cost and limited availability. In this study, we explore the feasibility of a sub 60‐minute protocol using a water challenge to assess gastric emptying, motility and accommodation in a cohort of Ehlers‐Danlos Syndrome‐Hypermobility type ( EDS ‐ HT ) patients presenting with dyspepsia. Methods Nine EDS ‐ HT patients (mean age 33, range: 26‐50 all female) with a history of dyspepsia were recruited together with nine‐matched controls. Subjects fasted for 6 hours prior to MRI . A baseline anatomical and motility scan was performed after which the subjects ingested 300 mL water. The anatomical and motility scans were then repeated every 10 minutes to a total of 60 minutes. Gastric emptying time, motility, and accommodation were calculated based on the observations of two observers for each EDS ‐ HT subject and compared to their matched control using paired statistics. Key Results Median motility increase following the water challenge was lower in EDS ‐ HT subjects (11%, range: 0%‐22%) compared to controls (22%, range: 13%‐56%), P =.03. Median gastric emptying time was non‐significantly decreased in EDS ‐ HT subjects (12.5 minutes, range: 6‐27) compared to controls (20 minutes, range: 7‐30), P =.15. Accommodation was non‐significantly reduced in EDS ‐ HT subjects (56% increase, range: 32%‐78%) compared to healthy controls (67% increase, range: 52%‐78%), P =.19. Conclusions & Inferences This study demonstrates the feasibility of a water challenge MRI protocol to evaluate gastric physiology in the clinical setting. Motility differences between EDS ‐ HT and controls are worthy of further investigation.