title: Clinical significance of scintigraphic rapid gastric emptying.
abstract: OBJECTIVE
  To analyse our results of gastric-emptying scintigraphy in relation to presenting symptoms, and examine in detail the clinical significance of rapid gastric emptying (RGE).
  
  
  METHODS
  Results of 642 consecutive patients who underwent a solid gastric-emptying scintigraphy in our department over an 11-year period were retrospectively reviewed with particular emphasis to the presenting symptoms and the clinical profile of patients, especially of those who showed an accelerated pattern of emptying.
  
  
  RESULTS
  Seventy (11%) patients were clinically suspected to have a RGE and 572 (89%) patients had presumed gastroparesis. Gastric emptying was found to be normal in 290 (45%), rapid in 182 (28%) and delayed in 170 (27%) patients. Normal, rapid and delayed gastric emptying were seen, respectively, in 17 (24%), 48 (69%) and five (7%) patients with the clinical suspicion of dumping and 273 (48%), 134 (23%) and 165 (29%) patients with suspected gastroparesis. The positive predictive value of clinical suspicion for RGE was 62%, whereas the positive predictive value of delayed gastric emptying was 29%. Of the 182 patients with RGE, 144 (79%) were found to have no obvious explanation for this result; reactive hypoglycaemia was present in a quarter of these patients, but diarrhoea was seen only in 3%.
  
  
  CONCLUSIONS
  Upper gastrointestinal symptoms have a poor clinical specificity to the actual rate of gastric emptying on scintigraphy. Diarrhoea as a symptom does not appear to be associated frequently with RGE, but our results confirm its relationship with hypoglycaemia. The majority of patients with a rapid emptying on gastric-emptying scintigraphy have no identifiable cause for an accelerated motility. Scintigraphic gastric-emptying studies provide a reliable and noninvasive method of investigation in patients where conventional investigations have failed to establish the cause of upper gastrointestinal dysfunction.
authors.affiliation: Departments of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, United Kingdom. kottekkattu.balan@addenbrookes.nhs.uk
authors.forename: Kottekkattu
authors.initials: K
authors.lastname: Balan
authors.forename: Luke I
authors.initials: LI
authors.lastname: Sonoda
authors.forename: Nagabhushan
authors.initials: N
authors.lastname: Seshadri
authors.forename: Chandra
authors.initials: C
authors.lastname: Solanki
authors.forename: Stephen
authors.initials: S
authors.lastname: Middleton
mesh_terms: D004377:Dumping Syndrome / Q000150:complications; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005767:Gastrointestinal Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D018589:Gastroparesis / Q000000981:diagnostic imaging; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012737:Sex Factors; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging*