Severity of dyspeptic symptoms correlates with delayed and early variables of gastric emptying

Dig Dis Sci. 2013 Feb;58(2):478-87. doi: 10.1007/s10620-012-2355-5. Epub 2012 Aug 24.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Diabetes Complications / physiopathology
  • Dyspepsia / diagnostic imaging*
  • Dyspepsia / physiopathology
  • Female
  • Gastric Emptying / physiology*
  • Gastroparesis / diagnostic imaging*
  • Gastroparesis / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Nausea / diagnostic imaging
  • Nausea / physiopathology
  • Prospective Studies
  • Radionuclide Imaging / methods*
  • Severity of Illness Index*
  • Surveys and Questionnaires
  • Vomiting / diagnostic imaging
  • Vomiting / physiopathology