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Gastric Emptying Studies

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Gastrointestinal Motility Disorders

Abstract

Gastric emptying studies generally measures overall gastric emptying. They are primarily used to help diagnose patients with gastroparesis. The can also be useful for detecting rapid gastric emptying which might suggest dumping syndrome. There are three types of gastric emptying studies approved for clinical use: gastric emptying scintigraphy, breath testing using stable nonradioactive C-13 isotope, and wireless motility capsule. In addition, ultrasonography and magnetic resonance imaging (MRI) can be used to assess gastric emptying in clinical research studies. This chapter will discuss each of these tests mentioning aspects on how to perform the tests, how to interpret the tests, and use in patient management.

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Authors and Affiliations

  1. Gastroenterology Section, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA, 19140, USA

    Henry P. Parkman M.D.

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  1. Henry P. Parkman M.D.
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Correspondence to Henry P. Parkman M.D. .

Editor information

Editors and Affiliations

  1. Institute of Gastroenterology, Sheba medical Center, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel

    Eytan Bardan

  2. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

Appendix

Appendix

Common Patient Asked Question

1. My recent gastric emptying test was normal, though it was delayed in the past and I was told I had gastroparesis. What do I have?

Gastric emptying testing is needed to diagnose gastroparesis. The standard gastric emptying test is gastric emptying scintigraphy, which uses a radiolabeled isotope bound to solid food to image the meal emptying. However, there is variable methodology used at different centers. Standardization of gastric emptying among different centers has been suggested using a 4 h imaging protocol with scans taken 0, 1, 2, 4 h after ingestion of a radioactive Tc-99m labeled low-fat egg white with jam and 2 pieces of toast. The shorter duration tests lasting 60–90 min using different meals are not as helpful. Relatively high variability in gastric emptying constitutes another limitation of gastric motor testing. Unfortunately, gastric emptying rates measured by gastric motor testing do not correlate well with symptoms of gastroparesis. Patients can have severe nausea and vomiting with normal gastric emptying. These patients also represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. These findings suggest that factors in addition to slow gastric emptying contribute to symptoms.

Suggested Reading

Abell TL, Camilleri M, Donohoe K, Hasler WL, Lin HC, Maurer AH, McCallum RW, Nowak T, Nusynowitz ML, Parkman HP, Shreve P, Szarka LA, Snape WJ Jr, Ziessman HA; American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol. 2008 Mar;103(3):753–63.

Pathikonda M, Sachdeva P, Malhotra N, Fisher RS, Maurer AH, Parkman HP. Gastric emptying scintigraphy: is four hours necessary? J Clin Gastroenterol. 2012 Mar; 46(3):209-15.

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Parkman, H.P. (2018). Gastric Emptying Studies. In: Bardan, E., Shaker, R. (eds) Gastrointestinal Motility Disorders . Springer, Cham. https://doi.org/10.1007/978-3-319-59352-4_28

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  • DOI: https://doi.org/10.1007/978-3-319-59352-4_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59350-0

  • Online ISBN: 978-3-319-59352-4

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