91133 Electrogastrography, diagnostic, transcutaneous; with provocative testing

Name of the Procedure:

Electrogastrography, Diagnostic, Transcutaneous; with Provocative Testing (EGG)

Summary

Electrogastrography (EGG) is a non-invasive procedure that records the electrical signals generated by the stomach. It is performed through the skin (transcutaneous), often with the addition of provocative testing, such as eating a meal, to assess the stomach's electrical activity under different conditions.

Purpose

Electrogastrography is used to diagnose and evaluate disorders related to abnormal gastric electrical rhythms, such as gastroparesis or functional dyspepsia. The goal is to identify irregularities in the wave patterns that may be causing gastrointestinal symptoms and to guide appropriate treatment.

Indications

• Symptoms of nausea or vomiting
• Bloating or early satiety (feeling full quickly)
• Unexplained upper abdominal pain or discomfort
• Suspected disorders like gastroparesis or other motility issues
• Assessment of gastric function in clinical research

Preparation

• Patients may be required to fast (not eat or drink) for at least 6 hours before the procedure.
• Certain medications that can affect gastric motility may need to be adjusted or discontinued before the test.
• Patients may undergo an initial clinical evaluation to rule out other conditions.

Procedure Description

1. The patient is asked to lie down comfortably, and the skin on the abdomen is cleaned.
2. Electrode sensors are placed on the patient’s abdomen to detect electrical activity.
3. Baseline electrical signals are recorded while the patient is at rest.
4. Provocative testing is conducted, usually involving the ingestion of a meal or a specific test meal.
5. Additional recordings are taken during and after the meal to assess the stomach's response to food.
6. The data is analyzed to compare electrical patterns before and after the meal.

Duration

The procedure typically takes about 1 to 2 hours, including time for preparation, recording, and post-meal monitoring.

Setting

The procedure is usually conducted in an outpatient clinic, hospital, or specialized gastrointestinal diagnostic center.

Personnel

• Gastroenterologist or a specialized physician
• Trained technician or nurse to assist with electrode placement and monitoring
• Medical staff for patient support

Risks and Complications

• Minor skin irritation or discomfort from electrode placement
• Rarely, the provocative meal may cause temporary gastrointestinal discomfort
• Electrogastrography is generally considered safe with minimal risks

Benefits

• Non-invasive and painless way to assess stomach function
• Helps in diagnosing unexplained gastrointestinal symptoms
• Can guide effective treatment plans for motility disorders
• Results can be available quickly for immediate analysis

Recovery

• Patients can typically resume normal activities immediately after the procedure.
• Follow any specific dietary or medication instructions provided by the healthcare provider.
• A follow-up appointment may be scheduled to discuss the results and any needed treatment.

Alternatives

• Gastric emptying studies using radioactive isotopes
• Endoscopy for direct visualization of the stomach
• Hydrogen breath tests for other digestive issues
• Each alternative has different pros and cons, such as varying invasiveness and diagnostic capabilities.

Patient Experience

• Patients may feel slight discomfort or stickiness from the electrodes.
• During the meal phase, patients should eat the test meal as instructed.
• The procedure is generally well-tolerated with minimal pain.
• Comfort measures are provided throughout, and staff are available to address any concerns.