INTRODUCTION: Recommendations for gastric emptying scintigraphy (GES) suggest imaging over 4 hours to better define gastroparesis. AIMS: To determine the value of defining delayed gastric emptying at time points earlier than 4 hours. METHODS: GES was performed with ingestion of a liquid egg white meal with imaging at 0, 0.5, 1, 2, 3, and 4 hours. Patients completed the Patient Assessment of Gastrointestinal Symptoms questionnaire immediately before GES. RESULTS: Of 1499 patients undergoing GES from September 2007 to January 2010 (76.2% were female, mean age of 45.5±0.5 y, 21.3% had diabetes, 9.5% had earlier gastric surgery), 160 (10.7%) had increased gastric retention at 1 hour (>90%), 404 (27%) had increased retention at 2 hours (>60%), 576 (38.4%) had increased retention at 3 hours (>30%), and 629 (42%) had increased retention at 4 hours (>10%). Gastric retention at 4 hours correlated with retention at 3 hours (r=0.890; P<0.001), 2 hours (r=0.738; P<0.001), and 1 hour (r=0.510; P<0.001). Symptoms correlated better with the gastric retention at later time points. The symptoms correlating with gastric retention at 4 hours included early satiety (r=0.170; P<0.01), vomiting (r=0.143; P<0.01), feeling excessively full after meals (r=0.123; P<0.01), and loss of appetite (r=0.122; P<0.01). CONCLUSIONS: Gastric retention at 4 hours correlates well with gastric retention at 3 hours, good at 2 hours, but only fair with gastric retention at 1 hour. Gastric retention at 1 hour may miss 36% of patients found to have delayed gastric emptying at 4 hours. Symptoms (early satiety, vomiting, feeling excessively full after meals, and loss of appetite) correlated better with the gastric retention at later time points.
INTRODUCTION: Recommendations for gastric emptying scintigraphy (GES) suggest imaging over 4 hours to better define gastroparesis. AIMS: To determine the value of defining delayed gastric emptying at time points earlier than 4 hours. METHODS: GES was performed with ingestion of a liquid egg white meal with imaging at 0, 0.5, 1, 2, 3, and 4 hours. Patients completed the Patient Assessment of Gastrointestinal Symptoms questionnaire immediately before GES. RESULTS: Of 1499 patients undergoing GES from September 2007 to January 2010 (76.2% were female, mean age of 45.5±0.5 y, 21.3% had diabetes, 9.5% had earlier gastric surgery), 160 (10.7%) had increased gastric retention at 1 hour (>90%), 404 (27%) had increased retention at 2 hours (>60%), 576 (38.4%) had increased retention at 3 hours (>30%), and 629 (42%) had increased retention at 4 hours (>10%). Gastric retention at 4 hours correlated with retention at 3 hours (r=0.890; P<0.001), 2 hours (r=0.738; P<0.001), and 1 hour (r=0.510; P<0.001). Symptoms correlated better with the gastric retention at later time points. The symptoms correlating with gastric retention at 4 hours included early satiety (r=0.170; P<0.01), vomiting (r=0.143; P<0.01), feeling excessively full after meals (r=0.123; P<0.01), and loss of appetite (r=0.122; P<0.01). CONCLUSIONS:Gastric retention at 4 hours correlates well with gastric retention at 3 hours, good at 2 hours, but only fair with gastric retention at 1 hour. Gastric retention at 1 hour may miss 36% of patients found to have delayed gastric emptying at 4 hours. Symptoms (early satiety, vomiting, feeling excessively full after meals, and loss of appetite) correlated better with the gastric retention at later time points.
Authors: Houssam Halawi; Michael Camilleri; Andres Acosta; Maria Vazquez-Roque; Ibironke Oduyebo; Duane Burton; Irene Busciglio; Alan R Zinsmeister Journal: Am J Physiol Gastrointest Liver Physiol Date: 2017-08-03 Impact factor: 4.052
Authors: Perry Orthey; Daohai Yu; Mark L Van Natta; Frederick V Ramsey; Jesus R Diaz; Paige A Bennett; Andrei H Iagaru; Roberto Salas Fragomeni; Richard W McCallum; Irene Sarosiek; William L Hasler; Gianrico Farrugia; Madhusudan Grover; Kenneth L Koch; Linda Nguyen; William J Snape; Thomas L Abell; Pankaj J Pasricha; James Tonascia; Frank Hamilton; Henry P Parkman; Alan H Maurer Journal: J Nucl Med Date: 2017-09-28 Impact factor: 10.057
Authors: Michael Camilleri; Henry P Parkman; Mehnaz A Shafi; Thomas L Abell; Lauren Gerson Journal: Am J Gastroenterol Date: 2012-11-13 Impact factor: 10.864