Gastric emptying in infants with gastroesophageal reflux. Measurement with a technetium-99m-labeled semisolid meal.
It is well established that liquid emptying occurs in the absence of motor activity of the stomach. In contrast, solid-phase emptying is controlled in part by antral peristalsis and is, therefore, a more precise indicator of gastric motility. We developed a semisolid, radionuclide gastric emptying test using rice cereal and technetium-99m-sulfur colloid to assess antral physiology in infants with vomiting. Computer-programmed mathematical models were used to determine the shape of a line that best fit our emptying data points. Linear, simple exponential [f = 2-(t/t1/2)], and power exponential [f = 2(t/t1/2)beta] patterns of emptying were calculated, where f is the fraction of the meal remaining in the stomach at time t, and t1/2 is the time when 50% of the meal has emptied and is a determinant of the shape of the curve. In infants with simple regurgitation (chalasia) and those with vomiting and failure to gain weight, we made statistical comparisons between gastric emptying patterns after analysis of the mean percentage of retained radionuclide at 120 min, calculated t1/2, and area under the curve. The coefficient of determination, R2, was calculated as an index of whether a curve provided goodness of fit to the data. Differences between groups of patients were statistically significant for all parameters of each mathematical model. However, higher coefficients of determination were noted in the power exponential model. The data suggest that the power exponential mathematical model provides the best analysis of the gastric emptying patterns for infants with chalasia and those with vomiting and failure to gain weight.(ABSTRACT TRUNCATED AT 250 WORDS)
Andres
J M
JM
Department of Pediatrics, University of Florida, Gainesville 32610.
Mathias
J R
JR
Clench
M H
MH
Davis
R H
RH
D000327:Adsorption; D005183:Failure to Thrive / Q000209:etiology / Q000503:physiopathology; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007700:Kinetics; D008954:Models, Biological; D012275:Oryza; D011877:Radionuclide Imaging; D013671:Technetium Tc 99m Sulfur Colloid; D014839:Vomiting / Q000209:etiology / Q000503:physiopathology
D013671:Technetium Tc 99m Sulfur Colloid