Assessment of Gastric Emptying (Comparison of Solid Scintigraphic Emptying and Emptying of Radiopaque Markers in Patients and Healthy Subjects)

The gold standard for measuring gastric emptyingis scintigraphy, either with digestible solids orliquids. Unfortunately, this method is expensive and oflimited availability. An alternative could be to use radiopaque markers (ROMs). Our aim was tocompare these two tests in healthy volunteers and inpatients to see whether emptying of ROMs can substitutefor scintigraphic solid emptying. We also intended to see if patients with small intestinalbacterial overgrowth (SIBO) had delayed gastricemptying. Twenty healthy subjects and 21 patients, 11with SIBO and 10 with insulin-dependent diabetesmellitus (IDDM), were included. A standard meal with a[^99mTc]MAA-labeled omelet and 20 ROMs wasgiven. Scintigraphic emptying and ROM emptying werefollowed simultaneously. Reference values for gastricemptying of ROMs were determined in 50 healthy subjects. Thescintigraphic method and the radiologic methodcorrelated significantly in healthy subjects (P <0.05), and in patients (P < 0.001), when comparinghalf-emptying time for both methods. Scintigraphichalf-emptying time correlated significantly withemptying of ROMs after 6 hr. Six of 11 patients withSIBO (P < 0.02) and 7/10 patients with IDDM (P <0.02) had delayed scintigraphic emptying of solids usingthe 95th percentile in the controls as the upperreference value. Gastric emptying of ROMs was, similarto solid scintigraphic gastric emptying, slower in women than in men. In conclusion, scintigraphicemptying of solids and emptying of ROMs are closelycorrelated. The radiologic method can be used as asimpler and more readily available method. Women have slower gastric emptying of ROMs than men, whichnecessitates separate reference values. A highproportion of patients with symptomatic IDDM and withSIBO have delayed gastric emptying.