Skip to main content
Top
Published in: Digestive Diseases and Sciences 2/2013

01-02-2013 | Original Article

Severity of Dyspeptic Symptoms Correlates with Delayed and Early Variables of Gastric Emptying

Authors: Andres Ardila-Hani, Mane Arabyan, Alan Waxman, Grace Ih, Dror Berel, Mark Pimentel, Jeffrey Conklin, Edy E. Soffer

Published in: Digestive Diseases and Sciences | Issue 2/2013

Login to get access

Abstract

Background

A simplified report of gastric retention values at select times is now recommended for scintigraphic gastric emptying test (GET).

Aims

The purpose of this study was to assess correlation between severity of gastroparetic symptoms and all variables of GET, compared to select variables in clinical use.

Methods

This was a prospective study of patients referred for scintigraphic GET. The Gastroparesis Cardinal Symptom Index questionnaire was obtained prior to the scintigraphy. Variables determined were lag time, half emptying time (T1/2), retention at 30 min, 1, 2 and 4 h. Statistical analysis was by Spearman rank correlation and Wilcoxon rank test with a significance set at p ≤ 0.05.

Results

Seven hundred seventeen patients had GET from 03/09 to 03/11. Results are from 325 patients who did not take medications known to affect GET were analyzed (64.9 % females, mean age 47 ± 18.9 years, 21.8 % diabetics, 78.2 % non-diabetic, of which 7.6 % were post-surgical, primarily post-fundoplication). Combined gastric retention at 2 and 4 h detected delayed GET in 83.5 % non-diabetics and 76.6 % of diabetics. Rapid GET was present in 11 % of patients at 30 min and 4 % at 1 h. Significant positive correlation was observed between nausea, vomiting, loss of appetite and variables of GET, but not with the half-time of emptying (T1/2). Bloating negatively correlated with retention at 2 h. There was no association between duration of symptoms and GET variables.

Conclusions

Gastroparetic symptoms correlate with different retention times of GET, but not with T1/2. However, symptoms poorly distinguish between categories of gastroparesis or status of gastric emptying. Delayed GE is best detected by 2 and 4 h retention times, while 30 min and 1 h retention times detect rapid GE.
Literature
1.
go back to reference Abell TL, Camilleri M, Donohoe K, Hasler WL, et al. Consensus recommendations for gastric emptying scintigraphy. A joint report of the society of nuclear medicine and the American neuro-gastroenterology and motility society. Am J Gastroenterol. 2008;103:753–763.PubMedCrossRef Abell TL, Camilleri M, Donohoe K, Hasler WL, et al. Consensus recommendations for gastric emptying scintigraphy. A joint report of the society of nuclear medicine and the American neuro-gastroenterology and motility society. Am J Gastroenterol. 2008;103:753–763.PubMedCrossRef
2.
go back to reference Cremonini F, Mullan BP, Camilleri M, Burton DD, Rank MR. Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther. 2002;16:1781–1790.PubMedCrossRef Cremonini F, Mullan BP, Camilleri M, Burton DD, Rank MR. Performance characteristics of scintigraphic transit measurements for studies of experimental therapies. Aliment Pharmacol Ther. 2002;16:1781–1790.PubMedCrossRef
3.
go back to reference Thomforde GM, Camilleri M, Phillips SF, Forstrom LA. Evaluation of an inexpensive screening scintigraphic test of gastric emptying. J Nucl Med. 1995;36:93–96.PubMed Thomforde GM, Camilleri M, Phillips SF, Forstrom LA. Evaluation of an inexpensive screening scintigraphic test of gastric emptying. J Nucl Med. 1995;36:93–96.PubMed
4.
go back to reference Ziessman HA, Bonta DV, Goetze S, Ravich WJ. Experience with a simplified, standardized 4-hour gastric-emptying protocol. J Nucl Med. 2007;48:568–572.PubMedCrossRef Ziessman HA, Bonta DV, Goetze S, Ravich WJ. Experience with a simplified, standardized 4-hour gastric-emptying protocol. J Nucl Med. 2007;48:568–572.PubMedCrossRef
5.
go back to reference Guo JP, Maurer AH, Fisher RS, Parkman HP. Extending gastric emptying scintigraphy from two to four hours detects more patients with gastroparesis. Dig Dis Sci. 2001;46:24–29.PubMedCrossRef Guo JP, Maurer AH, Fisher RS, Parkman HP. Extending gastric emptying scintigraphy from two to four hours detects more patients with gastroparesis. Dig Dis Sci. 2001;46:24–29.PubMedCrossRef
6.
go back to reference Pathikonda M, Sachdeva P, Malhotra N, et al. Gastric emptying scintigraphy. Is four hours necessary?. J Clin Gastroenterol. 2012;46:209–215.PubMedCrossRef Pathikonda M, Sachdeva P, Malhotra N, et al. Gastric emptying scintigraphy. Is four hours necessary?. J Clin Gastroenterol. 2012;46:209–215.PubMedCrossRef
7.
go back to reference Tougas G, Eaker EY, Abell TL, Abrahamsson H, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000;95:1456–1462.PubMedCrossRef Tougas G, Eaker EY, Abell TL, Abrahamsson H, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000;95:1456–1462.PubMedCrossRef
8.
go back to reference Abell TL, Starkebaum W, Abidi N, et al. How common is rapid gastric emptying in gastroparesis. Gastroenterology. 2006;130:A244–A245. Abell TL, Starkebaum W, Abidi N, et al. How common is rapid gastric emptying in gastroparesis. Gastroenterology. 2006;130:A244–A245.
9.
go back to reference Revicki DA, Rentz AM, Dubois D, Kahrilas P, et al. Development and validation of a patient-assessed gastroparesis symptom severity measure: the gastropareis cardinal symptom index. Aliment Pharmacol Ther. 2003;18:141–150.PubMedCrossRef Revicki DA, Rentz AM, Dubois D, Kahrilas P, et al. Development and validation of a patient-assessed gastroparesis symptom severity measure: the gastropareis cardinal symptom index. Aliment Pharmacol Ther. 2003;18:141–150.PubMedCrossRef
10.
go back to reference Revicki DA, Rentz AM, Dubois D, et al. Gastroparesis cardinal symptom index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004;13:833–844.PubMedCrossRef Revicki DA, Rentz AM, Dubois D, et al. Gastroparesis cardinal symptom index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004;13:833–844.PubMedCrossRef
11.
go back to reference Talley NJ, Verlinden M, Jones M. Can symptoms discriminate among those with delayed or normal gastric emptying in dysmotility-like dyspepsia? Am J Gastroenterol. 2001;96:1422–1428.PubMedCrossRef Talley NJ, Verlinden M, Jones M. Can symptoms discriminate among those with delayed or normal gastric emptying in dysmotility-like dyspepsia? Am J Gastroenterol. 2001;96:1422–1428.PubMedCrossRef
12.
go back to reference Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol. 2003;98:783–788.PubMedCrossRef Sarnelli G, Caenepeel P, Geypens B, Janssens J, Tack J. Symptoms associated with impaired gastric emptying of solids and liquids in functional dyspepsia. Am J Gastroenterol. 2003;98:783–788.PubMedCrossRef
13.
go back to reference Stanghellini V, Tosetti C, Paternico A, et al. Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia. Gastroenterology. 1996;110:1036–1042.PubMedCrossRef Stanghellini V, Tosetti C, Paternico A, et al. Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia. Gastroenterology. 1996;110:1036–1042.PubMedCrossRef
14.
go back to reference Perri F, Clemente R, Festa V, et al. Patterns of symptoms in functional dyspepsia: role of Helicobacter pylori infection and delayed gastric emptying. Am J Gastroenterol. 1998;43:2028–2033. Perri F, Clemente R, Festa V, et al. Patterns of symptoms in functional dyspepsia: role of Helicobacter pylori infection and delayed gastric emptying. Am J Gastroenterol. 1998;43:2028–2033.
15.
go back to reference Khayyam U, Sachdeva P, Gomez J, Ramzan Z, et al. Assessment of symptoms during gastric emptying scintigraphy to correlate symptoms to delayed gastric emptying. Neurogastroenterol Motil. 2010;22:539–545.PubMed Khayyam U, Sachdeva P, Gomez J, Ramzan Z, et al. Assessment of symptoms during gastric emptying scintigraphy to correlate symptoms to delayed gastric emptying. Neurogastroenterol Motil. 2010;22:539–545.PubMed
16.
go back to reference Hasler WL, Wilson LA, Parkman HP, et al. Bloating in gastroparesis: severity, impact, and associated factors. Am J Gastroenterol. 2011;106:1492–1502.PubMedCrossRef Hasler WL, Wilson LA, Parkman HP, et al. Bloating in gastroparesis: severity, impact, and associated factors. Am J Gastroenterol. 2011;106:1492–1502.PubMedCrossRef
17.
go back to reference Jones KL, Russo A, Berry MK, Stevens JE, Wishart JM, Horowitz M. A longitudinal study of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus. Am J Med. 2002;113:449–455.PubMedCrossRef Jones KL, Russo A, Berry MK, Stevens JE, Wishart JM, Horowitz M. A longitudinal study of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus. Am J Med. 2002;113:449–455.PubMedCrossRef
18.
go back to reference Camilleri M, Zinsmeister AR, Greydanus MP, Brown ML, Proano M. Towards a less costly but accurate test of gastric emptying and small bowel transit. Dig Dis Sci. 1991;36:609–615.PubMedCrossRef Camilleri M, Zinsmeister AR, Greydanus MP, Brown ML, Proano M. Towards a less costly but accurate test of gastric emptying and small bowel transit. Dig Dis Sci. 1991;36:609–615.PubMedCrossRef
19.
go back to reference Bharucha AE, Camilleri M, Forstrom L, Zinsmeister AR. Relationship between clinical features and gastric emptying disturbances in diabetes mellitus. Clin Endocrinol. 2008;70:415–420.CrossRef Bharucha AE, Camilleri M, Forstrom L, Zinsmeister AR. Relationship between clinical features and gastric emptying disturbances in diabetes mellitus. Clin Endocrinol. 2008;70:415–420.CrossRef
20.
go back to reference Bharucha AE, Manduca A, Lake DS, et al. Gastric motor disturbances in patients with idiopathic rapid gastric emptying. Neurogastroenterol Motil. 2011;23:617–e252.PubMedCrossRef Bharucha AE, Manduca A, Lake DS, et al. Gastric motor disturbances in patients with idiopathic rapid gastric emptying. Neurogastroenterol Motil. 2011;23:617–e252.PubMedCrossRef
21.
go back to reference Delgado-Aros S, Camilleri M, Cremonini F, Ferber I, Stephens D, Burton DD. Contributions of gastric volumes and gastric emptying to meal size and postmeal symptoms in functional dyspepsia. Gastroenterology. 2004;127:1685–1694.PubMedCrossRef Delgado-Aros S, Camilleri M, Cremonini F, Ferber I, Stephens D, Burton DD. Contributions of gastric volumes and gastric emptying to meal size and postmeal symptoms in functional dyspepsia. Gastroenterology. 2004;127:1685–1694.PubMedCrossRef
22.
go back to reference Malhotra N, Pathikonda M, Sachdeva P, Maurer AH, Fisher RS, Parkman HP. Rapid gastric eng or gastroparesis: can one tell the difference in the clinic? Gastroenterology. 2010;138:W1388. Malhotra N, Pathikonda M, Sachdeva P, Maurer AH, Fisher RS, Parkman HP. Rapid gastric eng or gastroparesis: can one tell the difference in the clinic? Gastroenterology. 2010;138:W1388.
Metadata
Title
Severity of Dyspeptic Symptoms Correlates with Delayed and Early Variables of Gastric Emptying
Authors
Andres Ardila-Hani
Mane Arabyan
Alan Waxman
Grace Ih
Dror Berel
Mark Pimentel
Jeffrey Conklin
Edy E. Soffer
Publication date
01-02-2013
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 2/2013
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-012-2355-5

Other articles of this Issue 2/2013

Digestive Diseases and Sciences 2/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.