Magnetic resonance imaging as a method for evaluating the effect of drinking mineral water on motor-evacuation function

Abstract

BACKGROUND: One of the primary pathophysiological mechanisms of functional dyspepsia is a disruption in the postprandial reflex relaxation of the proximal part of the stomach, which results in an impairment of its motor-evacuation function. This impairment can be verified by magnetic resonance imaging with a stress drinking test. Correction of gastric relaxation accommodation disorders in functional dyspepsia is possible with the help of drinking mineral waters. However, further studies are required to assess the effect of these waters on the motor-evacuation function of the stomach. AIM: The study was aimed at comparative evaluation of the effect of intake of therapeutic medium mineralized sulfate-sodium-calcium mineral water and ordinary drinking water on gastric evacuation function using magnetic resonance tomography. MATERIALS AND METHODS: A two-fold magnetic resonance imaging procedure was conducted on an empty stomach using a closed-type Philips Intera 1.5T device (Philips, Netherlands) in 10 patients aged 22.8±1.2 years with a diagnosis of functional dyspepsia. On day 1, 200 ml of drinking water was used, and on day 2, 200 ml of mineral water was used. The examination was conducted in abdominal mode, with the subjects lying on their back. A slice thickness of 3 mm was used in coronal, axial, and sagittal projections, with images acquired every 5 minutes for 20 minutes. The following imaging modes were employed: T1, T2-weighted images, T2 Spair, and b-FFE. The volume of gastric contents and the rate of fluid evacuation were calculated using the RadiAnt DICOM Viewer program (Medixant, Poland). RESULTS: In patients with functional dyspepsia, the volume of liquid in the stomach after ingestion of 200 ml of drinking water was 163.71 ± 28.9 mL, while after ingestion of mineral water, the volume was 101.57 ± 26.88 mL. Furthermore, the volume of evacuated liquid after ingestion of mineral water was 1.040–2.5 times greater. By minute 15, the volume of liquid in the stomach was 8.0 ± 6.16 mL after mineral water intake and 58.85 ± 40.06 mL after drinking water. The mean gastric evacuation rate following ingestion of ordinary drinking water was 12.9 ± 5.29 mL/min, while that following ingestion of mineral water was 24.1 ± 4.53 mL/min (1.07–3.76 times greater). The increase in gastric evacuation rate observed in the examined subjects when using mineral water ranged from 7.58% to 276.21%. CONCLUSIONS: Magnetic resonance imaging of the stomach allows for the verification of the effect of mineral water on its motor-evacuation function, thus enabling the estimation of the rate of gastric emptying. A single intake of the studied mineral water has a prokinetic effect, which can be used to correct motor disorders in patients with functional dyspepsia.