Kenneth L. Koch, M.D., Professor
Dr. Kenneth Koch is a Professor of Internal Medicine and Head, Section on Gastroenterology at Wake Forest University School of Medicine. He completed his undergraduate and medical school degrees at the University of Iowa, Internal Medicine training at Milton S. Hershey Medical Center of Pennsylvania State University, and fellowship in gastroenterology at the University of Florida.
Dr. Koch's clinical and research interests include the pathophysiology of nausea and vomiting, gastroparesis, gastric dysrhythmias, and functional dyspepsia. He has authored numerous original works, chapters, and other contributions to the GI literature. Dr. Koch was selected as one of the "Best Doctors in America."


SYNOPSIS OF AREA OF INTEREST: 1) Gastric neuromuscular function in the post prandial condition, including sensations of stomach fullness and satiety; and 2) gastric neuromuscular dysfunction as indicated by gastroparesis and gastric dysrhythmias, which are physiological conditions associated with nausea and vomiting.

DETAILED AREA OF INTEREST: What is nausea? This question has driven my area of research interest for over 20 years. Nausea is a debilitating symptom, whether it occurs in an environment of motion (ex., motion sickness) or during therapy (ex., chemotherapy-induced nausea and vomiting). This interest has led me to investigate the nausea of motion sickness, nausea and vomiting of first trimester of pregnancy, post-surgical and diabetic gastroparesis, and unexplained nausea. A technology we have used extensively to study the stomach non-invasively is the electrogastrogram, a recording of myoelectrical activity from the stomach. Healthy individuals are usually in a 3 cycle per minute rhythm; but during almost all types of nausea, the gastric rhythm becomes abnormal and is termed a tachygastria or bradygastria. We have described these dysrhythmias in a variety of nausea conditions.

We are also focusing our interest on the gastric electrical response to high fat or high protein liquid meals to assess the effect of these meals on gastric myoelectric activity and sensations of fullness, bloating, and nausea. We are part of a five-center consortium sponsored by the NIH to investigate gastroparesis related to post-surgical, diabetic, and idiopathic gastroparesis. Industry-related research is presently focused on the effect of digestive enzyme supplementation on test meals and gastric myoelectric and post prandial symptom profiles. A wireless capsule that records pH, pressure, and temperature as it moves through the digestive tract is also being studied in healthy subjects and in patients with gastroparesis or chronic constipation.

PUBLICATIONS:

Koch KL. Gastroparesis and neuromuscular disorders of the stomach. Minerva Gastroenterol Dietol. 2003; 49:107-122.

Stern R, Vitellaro K, Thomas M, Higgins S, Koch K. Electrogastrographic Biofeedback: A Technique for Enhancing Normal Gastric Activity. Neurogastroenterology Motil 2004; 16:753-757.

Levine ME, Stern RM, Koch KL. The effects of manipulating expectations through placebo and nocebo administration on gastric tachyarrhythmia and motion-induced nausea. Psychosomatic Medicine 2006;68:478-486.

Talley NJ, Camileri M, Burton D, Thomforde G, Koch K, Rucker MJ, Peterson J, Zinsmeister AR, Earnest DL. Double-blind placebo-controlled study to evaulate the effects of Tegaserod on gastric motor, sensory and myoelectrical function in healthy volunteers. Aliment Pharmacol Ther (In press, 2006).

Kuo B, McCallum RW, Koch KL, et al. SmartPill, a novel ambulatory diagnostic test for measuring gastric emptying in health and disease. Gastroenterol 2006; 130:A-434.

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