title: Use of a high caloric liquid meal as an alternative to a solid meal for gastric emptying scintigraphy.
abstract: BACKGROUND
  Gastric emptying scintigraphy (GES) using a solid meal is often recommended for the evaluation of gastroparesis. However, some patients cannot tolerate the standardized egg-white sandwich (EWS) solid meal and an alternative meal is needed.
  
  
  OBJECTIVE
  The aim of this study was to compare GES, regional gastric emptying, and gastric contractility using a liquid nutrient meal (LNM; Ensure Plus(®)) to those using EWS.
  
  
  METHODS
  Twenty healthy volunteers underwent GES using EWS and LNM on separate days. Gastric emptying was measured using scintigraphy and with a wireless motility capsule (WMC; SmartPill(®)).
  
  
  RESULTS
  The gastric emptying half-time with LNM was similar to that with EWS (1.41 ± 0.11 vs 1.52 ± 0.08 h; P = 0.28) and the two were significantly correlated (r = 0.53; P = 0.017). There were time-related differences in gastric emptying of the LNM compared to EWS: in the first hour, gastric retention of EWS was slightly greater than that of LNM, whereas at 3 and 4 h, gastric retention of EWS was slightly less than that of LNM. Regionally, the percentage retention of the meal in the proximal stomach was greater for EWS than for LNM at 0.5 h. WMC gastric emptying times and gastric contractility for the two meals were not significantly different.
  
  
  CONCLUSIONS
  Overall gastric emptying of the LNM was similar to that of the EWS meal. The LNM empties without a lag phase and takes slightly longer to empty from the distal stomach, likely due to its higher fat content. These differences are likely due to early accommodation with retention of solids in the proximal stomach and the need for trituration of solids. We conclude that this LNM can serve as an alternative to the conventional solid EWS for GES.
authors.affiliation: Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, 3401 North Broad Street, Philadelphia, PA 19140, USA.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Sachdeva
authors.forename: Steven
authors.initials: S
authors.lastname: Kantor
authors.forename: Linda C
authors.initials: LC
authors.lastname: Knight
authors.forename: Alan H
authors.initials: AH
authors.lastname: Maurer
authors.forename: Robert S
authors.initials: RS
authors.lastname: Fisher
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
mesh_terms: D000328:Adult; D053704:Capsule Endoscopy; D004529:Egg White; D005260:Female; D005526:Food, Formulated; D005746:Gastric Emptying; D018589:Gastroparesis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid; D014812:Vitamin K
chemical_list: C029401:Ensure Plus; D019275:Radiopharmaceuticals; D014812:Vitamin K; D013671:Technetium Tc 99m Sulfur Colloid