Severity of dyspeptic symptoms correlates with delayed and early variables of gastric emptying.
BACKGROUND
A simplified report of gastric retention values at select times is now recommended for scintigraphic gastric emptying test (GET).


OBJECTIVE
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.
Division of Gastroenterology, GI Motility Program, Cedars-Sinai Medical Center, 8730 Alden Drive, Los Angeles, CA 90048, USA.
Andres
A
Ardila-Hani
Mane
M
Arabyan
Alan
A
Waxman
Grace
G
Ih
Dror
D
Berel
Mark
M
Pimentel
Jeffrey
J
Conklin
Edy E
EE
Soffer
D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000503:physiopathology; D004415:Dyspepsia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D011877:Radionuclide Imaging / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000000981:diagnostic imaging / Q000503:physiopathology