Digestive Diseases and Sciences

, Volume 46, Issue 12, pp 2643–2650 | Cite as

Effect of Meal Size and Test Duration on Gastric Emptying and Gastric Myoelectrical Activity as Determined with Simultaneous [13C]Octanoate Breath Test and Electrogastrography in Normal Subjects Using a Muffin Meal

  • Sutep Gonlachanvit
  • William D. Chey
  • Keith J. Goodman
  • Henry P. Parkman


Our purpose was to determine the effect of meal size on gastric emptying (GE) as measured by octanoate breath test (OBT), to determine the effect of the duration of breath collections on assessment of GE by OBT, and to determine the effect of meal size on gastric myoelectrical activity as measured by electrogastrography (EGG). Fourteen normal subjects underwent two modified [13C]OBTs using muffin meals of 250 or 350 kcal mixed with 100 mg [13C]sodium octanoate. T1/2 for GE was determined for both the entire postprandial 6-hr breath collection and a truncated initial 4-hr data set. EGG was recorded for 30 min prior to the muffin meal and 4 hr postprandially. Using the 6-hr breath collection data, the T1/2 was 177 ± 7 (mean ± sem) for the 350-kcal meal compared to 153 ± 7 min (P < 0.01) for the 250-kcal meal. Using the 4-hr data, the T1/2 for the 350-kcal meal was 244 ± 32 min compared to 165 ± 12 min (P < 0.05) for the 250-kcal meal. The ratio of postprandial to fasting EGG power of the dominant frequency for the 350-kcal meal (1.9 ± 0.4) was higher than that for the 250-kcal meal (1.3 ± 0.6). T1/2 for the 350-kcal meal using 4- and 6-hr data was significantly correlated with the 4-hr power ratio (r = 0.68 and 0.67; P < 0.05, respectively), but poorly correlated for the 250-kcal meal. In conclusions, GE and EGG are affected by meal size. Using the muffin-based [13C]OBT, T1/2 for the 350-kcal meal was significantly longer than for a 250-kcal meal. Longer T1/2 values were obtained with shorter breath sampling durations. The postprandial to fasting power ratio for the 350-kcal meal was greater than that for the 250-kcal meal.

octanoic acid breath test gastric emptying electrogastrography 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Talley NJ, Silverstein MD, Agreus L, Nyren O, Sonnenberg A, Holtmann G: Evaluation of dyspepsia. Gastroenterology 114:582–595, 1998Google Scholar
  2. 2.
    Parkman HP, Miller MA, Trate D, Knight LC, Urbain JL, Maurer AH, Fisher RS: Electrogastrography and gastric emptying scintigraphy are complementary for assessment of dyspepsia. J Clin Gastroenterol 24:214–219, 1997Google Scholar
  3. 3.
    Camilleri M, Hasler W, Parkman HP, Quigley EMM, Soffer E: Measurement of gastroduodenal motility in the GI laboratory. Gastroenterology 115:747–762, 1998Google Scholar
  4. 4.
    Ghoos YF, Maes BD, Geypens BJ, Mys G, Hiele MI, Rutgeerts PJ, Vantrappen G: Measurement of gastric emptying rate of solids by means of a carbon-labeled octanoic acid breath test. Gastroenterology 104:1640–1647, 1993Google Scholar
  5. 5.
    Choi MG, Camilleri M, Burton DD, Zinsmeister AR, Forstrom LA, Nair KS: 13C-octanoic acid breath test for gastric emptying of solids: Accuracy, reproducibility, and comparison with scintigraphy. Gastroenterology 112:1155–1162, 1997Google Scholar
  6. 6.
    Duan LP, Braden B, Caspary WF, Lembcke B: Influence of cisapride on gastric emptying of solids and liquids monitored by 13C breath tests. Dig Dis Sci 40:2200–2206, 1995Google Scholar
  7. 7.
    Galmiche JP, Delbende B, Perri F, Andriulli A: 13C octanoic acid breath test. Gut 43Suppl 3:S28–S30, 1998Google Scholar
  8. 8.
    Choi MG, Camilleri M, Burton DD, Zinsmeister AR, Forstrom LA, Nair KS: Reproducibility and simplification of 13C-octanoic acid breath test for gastric emptying of solids. Am J Gastroenterol 93:92–98, 1998Google Scholar
  9. 9.
    McHugh PR, Moran TH: Calories and gastric emptying: A regulatory capacity with implications for feeding. Am J Physiol 236:R254–R260, 1979Google Scholar
  10. 10.
    Brener W, Hendrix TR, McHugh PR: Regulation of the gastric emptying of glucose. Gastroenterology 85:76–82, 1983Google Scholar
  11. 11.
    Moore JG, Christian PE, Coleman RE: Gastric emptying of varying meal weight and composition in man. Dig Dis Sci 26:16–22, 1981Google Scholar
  12. 12.
    Meyer JH, MacGregor IL, Guellar R, Martin P, Cavalieri R: 99m-Tc-tagged chicken liver as a market of solid food in the human stomach. Am J Dig Dis 21:296–304, 1976Google Scholar
  13. 13.
    Doren S, Jones KL, Andrews JM, Horowitz M: Effects of meal volume and posture on gastric emptying of solids and appetite. Am J Physiol 275:R1712–R1718, 1998Google Scholar
  14. 14.
    Chey WD, Shapiro B, Zawadski A, Goodman K: Gastric emptying characteristics of a novel 13C-octanoate labeled muf-fin meal. J Clin Gastroenterol 32:394–399, 2001Google Scholar
  15. 15.
    Parkman HP, Knight LC, Brown KL, Trate DM, Maurer AH, Fisher RS: Cholinergic effects on human gastric motility. Gut 45:346–354, 1999Google Scholar
  16. 16.
    Woolson RF: Statistical Methods for the Analysis of Biomedical Data. Probability and Statistics. New York, John Wiley & Sons, 1987, p. 513Google Scholar
  17. 17.
    Velchik MG, Reynolds JC, Alavi A: The effect of meal energy content on gastric emptying. J Nucl Med 30:1106–1110, 1989Google Scholar
  18. 18.
    Hunt JN, Stubbs DF: The volume and energy content of meals as determinants of gastric emptying. J Physiol 245:209–225, 1975Google Scholar
  19. 19.
    Lin HC, Doty JE, Reedy TJ, Meyer JH: Inhibition of gastric emptying by sodium oleate depends on length of intestine exposed to nutrient. Am J Physiol 259:G1030–G1036, 1990Google Scholar
  20. 20.
    Lee JS, Camilleri M, Zinsmeister AR, Burton DD, Kost LJ, Klein PD: A valid, accurate, office based non-radioactive test for gastric emptying of solids. Gut 46:768–773, 2000Google Scholar
  21. 21.
    Chen JD, McCallum RW: Clinical applications of electrogastrography. Am J Gastroenterol 88:1324–1336, 1993Google Scholar
  22. 22.
    Parkman HP, Harris AD, Miller MA, Fisher RS: Influence of age, gender, and menstrual cycle on the normal electrogastrogram. Am J Gastroenterol 91:127–133, 1996Google Scholar
  23. 23.
    Levanon D, Zhang M, Orr WC, Chen JDZ: Effects of meal volume and composition of gastric myoelectric activity. Am J Physiol 274:G430–G434, 1998Google Scholar
  24. 24.
    Koch KL, Stewart WR, Stern RM: Effect of barium meals on gastric electromechanical activity in man. A fluoroscopicelectrogastrographic study. Dig Dis Sci 32:1217–1222, 1987Google Scholar
  25. 25.
    Chen J, McCallum RW: Response of the electric activity in the human stomach to water and a solid meal. Med Biol Eng Comput 29:351–357, 1991Google Scholar
  26. 26.
    Chen JD, Richards RD, McCallum RW: Identification of gastric contractions from the cutaneous electrogastrogram. Am J Gastroenterol 89:79–85, 1994Google Scholar
  27. 27.
    Mintchev MP, Kingma YJ, Bowes KL: Accuracy of cutaneous recordings of gastric electrical activity. Gastroenterology 104:1273–1280, 1993Google Scholar
  28. 28.
    Guo J-P, Bonapace ES, Parkman HP, Fisher RS: The value of the second postprandial hour during electrogastrography (EGG) in symptomatic patients with and without gastroparesis. Dig Dis Sci 44:2150, 1999 (abstract)Google Scholar
  29. 29.
    Lin ZY, Sarosiek I, Denton S, Loftiss M, McCallum RW: Gastric dysrhythmia during the second postprandial hour correlates with gastrointestinal symptoms in patients with gastroparesis. Dig Dis Sci 45:1250, 2000 (abstract)Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Sutep Gonlachanvit
    • 1
  • William D. Chey
    • 2
  • Keith J. Goodman
    • 3
  • Henry P. Parkman
    • 1
  1. 1.Temple University School of MedicinePhiladelphia
  2. 2.University of Michigan Medical CenterAnn Arbor
  3. 3.Metabolic Solutions, Inc.Nashua

Personalised recommendations