Digestive Diseases and Sciences

, Volume 44, Issue 4, pp 729–734 | Cite as

Assessment of Gastric Emptying (Comparison of Solid Scintigraphic Emptying and Emptying of Radiopaque Markers in Patients and Healthy Subjects)

  • Per-Ove Stotzer
  • Martha Fjalling
  • Jakobina Gretarsdottir
  • Hasse Abrahamsson

Abstract

The gold standard for measuring gastric emptyingis scintigraphy, either with digestible solids orliquids. Unfortunately, this method is expensive and oflimited availability. An alternative could be to use radiopaque markers (ROMs). Our aim was tocompare these two tests in healthy volunteers and inpatients to see whether emptying of ROMs can substitutefor scintigraphic solid emptying. We also intended to see if patients with small intestinalbacterial overgrowth (SIBO) had delayed gastricemptying. Twenty healthy subjects and 21 patients, 11with SIBO and 10 with insulin-dependent diabetesmellitus (IDDM), were included. A standard meal with a[99mTc]MAA-labeled omelet and 20 ROMs wasgiven. Scintigraphic emptying and ROM emptying werefollowed simultaneously. Reference values for gastricemptying of ROMs were determined in 50 healthy subjects. Thescintigraphic method and the radiologic methodcorrelated significantly in healthy subjects (P <0.05), and in patients (P < 0.001), when comparinghalf-emptying time for both methods. Scintigraphichalf-emptying time correlated significantly withemptying of ROMs after 6 hr. Six of 11 patients withSIBO (P < 0.02) and 7/10 patients with IDDM (P <0.02) had delayed scintigraphic emptying of solids usingthe 95th percentile in the controls as the upperreference value. Gastric emptying of ROMs was, similarto solid scintigraphic gastric emptying, slower in women than in men. In conclusion, scintigraphicemptying of solids and emptying of ROMs are closelycorrelated. The radiologic method can be used as asimpler and more readily available method. Women have slower gastric emptying of ROMs than men, whichnecessitates separate reference values. A highproportion of patients with symptomatic IDDM and withSIBO have delayed gastric emptying.

BACTERIAL OVERGROWTH DIABETES MELLITUS GASTRIC EMPTYING SMALL INTESTINE 

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REFERENCES

  1. 1.
    Minami H, McCallum RW: The physiology and pathophysiology of gastric emptying in humans. Gastroenterology 86:1592-1610, 1984Google Scholar
  2. 2.
    Bertrand J, Metman E-H, Danquechin Dorval E, Rouleau Ph, D'Hueppe A, Itti R, Philippe L: Étude du temps d'evacuation gastrique de repas normaux au moyen de granules radioopaques. Applications cliniques et validation. Gastroenterol Clin Biol 4:770-776, 1980Google Scholar
  3. 3.
    Caballero-Plasencia AM, Muros-Navarro MC, Martin-Ruiz JL, Valenzue la-Barranco M, De Los Reyes-Garcia MC, Vilchez-Joya R, Casado-Caballero FJ, Gil-Extremera B: Gastroparesis of digestible and indigestible solids in patients with insulin-dependent diabetes mellitus or functional dyspepsia. Dig Dis Sci 39:1409-1415, 1994Google Scholar
  4. 4.
    Chang C-S, Chen G-H, Kao C-H, Wang S-J, Peng S-N, Poon S-K, Huang C-K: Gastric clearance of radiopaque markers in non-ulcer dyspepsia patients. Scand J Gastroenterol 31:136-139, 1996Google Scholar
  5. 5.
    Farrell FJ, Keeffe EB: Diabetic gastroparesis. Dig Dis 13:291-300, 1995Google Scholar
  6. 6.
    Feldman M, Smith HJ: Effect of cisapride on gastric emptying of indigestible solids in patients with gastroparesis diabeticorum.A comparison with metoclopramide and placebo. Gastroenterology 92:171-174, 1987Google Scholar
  7. 7.
    Tung C-F, Chang C-S, Chen G-H, Kao C-H, Wang S-J: Comprehensive gastric emptying study for type-II diabetes mellitus dyspeptic patients. Scand J Gastroenterol 32:884-887, 1997Google Scholar
  8. 8.
    Feldman M, Smith HJ, Simon TR: Gastric emptying of solid radiopaque markers: Studies in healthy subjects and diabetic patients. Gastroenterology 87:895-902, 1984Google Scholar
  9. 9.
    Loo FD, Palmer DW, Soergel KH, Kalbfleisch JH, Wood CM: Gastric emptying in patients with diabetes mellitus. Gastroenterology 86:485-494, 1984Google Scholar
  10. 10.
    Vantrappen G, Janssens J, Hellemans J, Ghoos Y: The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 59:1158-1166, 1977Google Scholar
  11. 11.
    Stotzer P-O, Björnsson EB, Abrahamsson H: Interdigestive and postprandial motility in small intestinal bacterial overgrowth. Scand J Gastroenterol 31:875-880, 1996Google Scholar
  12. 12.
    Grybäck P, Näslund E, Hellström PM, Jacobsson H, Backman L: Gastric emptying of solids in humans: Improved evaluation by Kaplan-Meier plots. Eur J Nucl Med 23:1562-1567, 1996Google Scholar
  13. 13.
    Tothill P, McLoughlin GP, Heading RC: Techniques and errors in scintigraphic measurements of gastric emptying. J Nucl Med 19:256-261, 1978Google Scholar
  14. 14.
    Kerlin P, Wong L: Breath hydrogen testing in bacterial overgrowth of the small intestine. Gastroente rology 95:982-988, 1988Google Scholar
  15. 15.
    Poitras P, Picard M, Dery R, Giguére A, Morais J, Plourde V, Boivin M: Evaluation of gastric emptying in clinical practice. Dig Dis Sci 42:2183-2189, 1997Google Scholar
  16. 16.
    Hinder RA, Kelly KA: Canine gastric emptying of solids and liquids. Am J Physiol 233( 4):E335-E340, 1977Google Scholar
  17. 17.
    Stotzer P-O, Abrahamsson H: Gastric emptying of nondigestible solids is not related to antral phase III. Neurogastroenterol Motil 10:101, 1998 (abstract)Google Scholar
  18. 18.
    Meyer JH, Dressman J, Fink A, Amidon G: Effect on size and density on canine gastric emptying of non-digestible solids. Gastroenterology 89:805-813, 1985Google Scholar
  19. 19.
    Meyer JH, Eliashoff J, Porter-Fink V, Dressman J, Amidon GL: Human postprandial gastric emptying of 1-3 millimeter spheres. Gastroenterology 94:1315-1325, 1988Google Scholar
  20. 20.
    Meyer B, Beglinger C, Neumayer M, Stalder GA: Physical characteristics of indigestible solids affect emptying from the fasting human stomach. Gut 30:1526-1529, 1989Google Scholar
  21. 21.
    Smith HJ, Feldman M: Influence of food and marker length on gastric emptying of indigestible radiopaque markers in healthy humans. Gastroenterology 91:1452-1455, 1986Google Scholar
  22. 22.
    Meyer JH, Ohashi H, Jehn D, Thomson JB: Size of liver particles emptied from the human stomach. Gastroenterology 80:1489-1496, 1981Google Scholar
  23. 23.
    Holt S, Reid J, Taylor TV, Tothill P, Heading RC: Gastric emptying of solids in man. Gut 23:292-296, 1982Google Scholar
  24. 24.
    Lin HC, Eliashoff JD, Yo-Guo Gu, Meyer JH: Effect of meal volume on gastric emptying. J Gastrointest Motil 4:157-163, 1992Google Scholar
  25. 25.
    Davis SS, Hardy JG, Fara JW: Transit of pharmaceutical dosage forms through the small intestine. Gut 27:886-892, 1986Google Scholar
  26. 26.
    Hermansson G, Sivertsson R: Gender-related differences in gastric emptying rate of solid meal. Dig Dis Sci 41:1994-1998, 1996Google Scholar
  27. 27.
    Code CF, Schlegel JF: The gastrointestinal interdigestive housekeeper: Motor correlates of the interdigestive myoelectric complex of the dog. In Proceedings from the Fourth International Symposium on Gastro-Intestinal Motility. Mitchell Press Ltd., Vancouver, Canada, 1973, pp 631-634Google Scholar
  28. 28.
    Husebye E, Skar V, Hù verstad T, Iversen T, Melby K: Abnormal intestinal motor patterns explain enteric colonization with gram-negative bacilli in late radiation enteropathy. Gastroenterology 109:1078-1089, 1995Google Scholar

Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Per-Ove Stotzer
  • Martha Fjalling
  • Jakobina Gretarsdottir
  • Hasse Abrahamsson

There are no affiliations available

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