Delay of gastric emptying by duodenal intubation: sensitive measurement of gastric emptying by the paracetamol absorption test.
OBJECTIVE
To examine the influence of duodenal intubation on gastric emptying measured by the paracetamol absorption test using a new algorithm developed to estimate emptying parameters, and to determine the sensitivity of this test.


METHODS
A caloric liquid meal with paracetamol as marker of emptying was administered orally to eight healthy volunteers during phase I and phase II of the migrating motor complex (MMC) and without intubation on 3 separate days, and to 10 patients with partial gastrectomy.


RESULTS
Healthy subjects: With duodenal tube, time until 25% of the meal had emptied (t25%) was 24+/-7 (phase I, P<0.02) and 21+/-6 min (phase II, P<0.02) compared with 14+/-4 min for meal intake without intubation. Time until 50% of the meal had emptied (t50%) was 45+/-8 (phase I, P<0.001) and 35+/-8 min (phase II, P<0.02) compared with 26+/-9 min for meal intake without intubation. Intraduodenal instillation of 10-20 mL of the liquid meal was reliably detected.


METHODS
In 9 out of 10 patients with partial gastrectomy t25% was below the lower limit of the range for healthy controls, and t25% detected accelerated emptying with a higher degree of sensitivity than the commonly applied pharmacokinetic parameters Cmax and Tmax.


CONCLUSIONS
A duodenal tube delays gastric emptying of a caloric liquid meal. The paracetamol absorption test emerges as a sensitive method suitable for detecting both delayed and accelerated gastric emptying of caloric liquid meals.
Medhus
A W
AW
Department of Medicine, Ullevål University Hospital of Oslo, Norway. asle.medhus@ioks.uio.no
Sandstad
O
O
Bredesen
J
J
Husebye
E
E
D000082:Acetaminophen / Q000493:pharmacokinetics*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005743:Gastrectomy; D005746:Gastric Emptying; D005755:Gastrins / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D005755:Gastrins; D007328:Insulin; D000082:Acetaminophen