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Title: Novel approaches to the measurement of gastrointestinal motor physiology
Author: Smith, David Monro
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1993
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Advances in gastrointestinal motility are hampered by current methodology. This thesis sought to evaluate novel methods for measurement of gastrointestinal motor physiology, including a) computerised analysis of gastric and small bowel motility and b) a non-invasive method of detection of gastrointestinal motor activity, termed Surface Vibration Analysis (SVA). SVA detects vibrational energy emanating from gastrointestinal contractions, using a transducer placed on the abdominal surface. The main objectives of this thesis were as follows: 1. Computerised analysis of gastrointestinal motility. Algorithms for peak detection, measurement of peak amplitude and duration, exclusion of artefact, identification of the individual phases of the Migrating Motor Complex (MMC) were constructed and validated against conventional manual analysis. This development was essential for the assessment of objective 2. 2. Comparison of SVA against intraluminal manometry. The SVA response was decreased during periods of motor quiescence (phase I of the MMC) as compared to motor activity (phases II & III of the MMC). This SVA response was increased by instillation of both gas and fluid in the upper gastrointestinal tract as compared to gas and fluid evacuation (GFE). There was no correlation between individual manometric contraction parameters and the SVA response. 3. Effects of intraluminal content on motility measurements. GFE reduced the duration and contraction amplitude of phase II of the MMC and increased the duration of phase I. Instillation of both gas and fluid had the converse effect. The parameters of phase III were unaffected. 4. Evaluation of SVA in chronic intestinal obstruction. SVA was applied to the detection of subacute intestinal obstruction in 46 patients and compared to 18 volunteers. On the basis of visual analysis of the SVA tracing, a positive diagnosis of subacute intestinal obstruction was made in 12 out of 14 patients subsequently proven to have adhesions at laparotomy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available