Delayed gastric emptying in gastroesophageal reflux disease: reassessment with new methods and symptomatic correlations.
BACKGROUND
Previous studies have shown that patients with gastroesophageal reflux disease (GERD) have slower rates of gastric emptying than control subjects, but the prevalence has differed because of variations in methodology. The recent establishment of international control values for scintigraphic gastric emptying assessment makes standardization of this technique possible. It would also be useful to determine whether specific gastrointestinal symptoms predicted delayed gastric emptying in GERD.


METHODS
Forty-nine patients (mean age, 42.9 years; range, 24-65 years; 35 women, 14 men) who were diagnosed with GERD in the previous 12 months were given a standardized 280-kcal 99Tc-labeled low fat meal (egg beater). Percentage of intragastric residual content was recorded at baseline and at hourly intervals for 240 minutes by scintigraphy. Patients were also asked about the presence of dyspepsia (bloating, postprandial discomfort or belching, or early satiety), dysphagia, or regurgitation.


RESULTS
Sixteen patients (33%) had intragastric residual contents greater than the 95th percentile (>40%) at 120 minutes, and 13 (26%) had abnormal results at 240 minutes (>6%). Dyspepsia was present in all patients. Regurgitation and dysphagia were common (present in approximately 80% and 40% of patients, respectively) and the prevalence of these symptoms did not differ between patients with normal versus delayed gastric emptying.


CONCLUSIONS
Using standardized techniques: 1) delayed gastric emptying is common in patients presenting with GERD at both 120 and 240 minutes after ingestion of a solid meal and 2) symptoms alone are not a useful predictor of this pathophysiology. Awareness of this subgroup of patients can be important in treatment strategies and long-term therapy.
Buckles
Daniel C
DC
Division of Gastroenterology and Hepatology, Department of Medicine, Kansas University Medical Center, Kansas City 66205, USA.
Sarosiek
Irene
I
McMillin
Chris
C
McCallum
Richard W
RW
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004415:Dyspepsia / Q000209:etiology; D005260:Female; D015902:Gamma Cameras; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000295:instrumentation / Q000379:methods*; D013270:Stomach / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013667:Technetium
D013667:Technetium