Gender-related differences in gastric emptying rate of solid meals

Controversy exists about the occurrence of a gender-related difference in gastric emptying in humans. In this paper, a strictly standardized scintigraphic method, in which pancakes were labeled with technetium-99m-macroaggregated albumin, was used to follow gastric emptying in 16 male and 14 female healthy young subjects. The resulting mean gastric emptying curves described biphasic patterns. There was a similar lag period (30.6±4.2 vs 33.6±3.8 min; means±SEM) but a faster linear gastric emptying rate (32.9±1.4 vs 22.0±1.3%/hr), a shorter half-emptying time (111.2±8.6 vs 158.2±6.4 min) and lower residual radioactivity after 2 hr (43.0±3.5 vs 62.8±1.7%) in the male subgroup as compared with the female subgroup. The differences were highly statistically significant. As a result, separate reference values are recommended for young male and fertile female subjects.     

The effect of metoclopramide on gastric emptying of solid meals

The effect of metoclopramide has been studied on the emptying of solid meals labelled with (51)Cr and monitored with a gamma camera.Metoclopramide, 10 mg iv or a dummy injection, was given randomly and double blind to 10 normal subjects and to 10 patients within three months of a truncal vagotomy and pyloroplasty. All were tested in the recumbent position.Metoclopramide had no effect on emptying rates in the normal subjects nor in four postvagotomy patients who had emptying within the normal range (T(1/2) 30-150 min). In six patients with abnormally delayed emptying (mean T(1/2) 369 min) metoclopramide produced a significant improvement (mean T(1/2) 194 min, p < 0.01).     

固、液体混合餐的胃排空研究

目的和方法:本文以~(131)I-BSA 和99mTc-DTPA 分别作为混合餐固、液体食物的标记物,检测35例慢性胃炎病人和10名健康志愿者的胃排空,其中两例受检者1周内进一步用~(99m)Tc-SC 复查固体排空,比较两次固体排空过程的相关性。在体外对上述3种放射性标记物在胃液、1mol/L NaCl 和0.1mol/L HCl 溶液中消化2小时,检测其稳定性。结果:~(131)I-BSA 和~(99m)Tc-SC 标记的固体食物经消化后的脱标率分别<2.87%和4.63%,~(99m)Tc-DTPA吸附于固相的吸附率<8.36%。固/液体排空曲线明显不同,固体排空有明显的延迟期,半排空时间较长,慢性胃炎病人固/液体排空时间均较正常对照组延长,两种固体标记物的排空曲线相似,相关性为 r=0.989(p<0.01),前、后两次排空相比,最大差值为9.2%,最小差值仅为0.8%。结论:~(131)I-BSA 作为固体标记物有较好的稳定性,可供临床选择用于胃排空的检测。     

Gastric emptying of oil from solid and liquid meals

Digestion of fat in pancreatic insufficiency (PI) is strongly affected by how rapidly fat enters the duodenum. We postulated that: (1) oil empties faster in PI than in normals and (2) in both, it empties in a load-dependent fashion. We used a gamma camera to test these ideas by comparing gastric emptying of iodine-123 iodinated oil in normal and pancreatic-insufficient subjects after 15 g of free oil were ingested in a small spaghetti meal and 60 g of oil were ingested in a large spaghetti meal and in a milk emulsion. Indium-113m marked gastric emptying of water in the milk. In both groups after all meals, oil emptied fastest initially, slowing later; and oil emptied three to four times faster when 60 g vs 15 g were ingested. There were no significant differences between the groups of subjects with respect to gastric emptying of the spaghetti meals, but the pancreatic-insufficient subjects emptied both oil and water faster from the milk emulsion than did the normal subjects. The slower emptying of oil in the normal subjects was associated with significantly more layering of oil to the top of the intragastric milk emulsion.     

Omeprazole causes delay in gastric emptying of digestible meals

We have studied gastric emptying of a solid, realistic meal (800 cal, 15% protein, 45% fat, 40% carbohydrate) in 21 healthy subjects twice, with and without a four-day pretreatment with 40 mg omeprazole. The last dose of the drug was taken 24 hr before the test, to avoid hypothetical nonsecretory side effects of the drug. Gastric emptying was measured by ultrasound of antral diameters. The results show that basal and maximal postprandial antral cross-sectional areas were the same during the two tests. A greater residual distension of the antrum was present throughout the study after the omeprazole treatment, the difference being significant at time 120 and 240. Omeprazole induced a highly significant delay in gastric emptying [control 199.6 (12.6) vs omeprazole 230.9 (12.7) min, mean (1sem);P<0.003]. The delay was not due to a prolonged lag phase, but rather to an effect on the slope of the emptying curve. This study shows that in normal subjects omeprazole delays gastric emptying of a digestible solid meal.     

Circadian variation in gastric emptying of meals in humans

Circadian changes in drug absorption have been documented for several orally administered drugs in humans. To determine whether gastric emptying could account for these changes, morning (8 AM) and evening (8 PM) gastric emptying rates were measured in 16 healthy male subjects synchronized with diurnal activity and nocturnal rest. Gastric emptying half-times for the evening meal were significantly (p less than 0.001) longer for solids but not liquids when compared with morning emptying half-times. The increase in evening meal emptying time (53.6%) may account for the evening delay in reaching peak plasma concentrations documented for several drugs.     

Infrared spectrometry based 13C-octanoic acid breath test in measuring human solid gastric emptying

BACKGROUND AND AIMS: Because of the convenience of non-dispersive infrared spectrometry (NDIRS), we attempted to validate the usefulness of NDIRS compared with scintigraphy in human solid gastric emptying (GE) measurement, and tried to establish the normal range of solid GE based on NDIRS. METHODS: Twelve healthy volunteers (three men, nine women) were recruited for simultaneous scintigraphy and 13C-octanoic acid breath test (13C-OABT) studies. Stomach half-emptying time (t1/2) and lag phase (tlag) were the two main GE parameters measured and correlated. The breath samples were analyzed using NDIRS every 10-15 min for a total of 6 h, while scintigraphy was taken minute by minute for the first 30 min, then hourly for 4 h. Another 32 healthy volunteers (19 men, 13 women) received only the 13C-OABT to measure their solid GE. RESULTS: A significant correlation for t1/2 was found between the breath test and scintigraphy (r = 0.85, P = 0.001), while tlag was also positively correlated (r = 0.73, P = 0.007). The reference range of t1/2B based on all 44 subjects was 89.4-185.1 min (135.9 +/- 21.1 min (mean +/- SD)), while the range for tlagB was 37.1-117.8 min (81.9 +/- 17.4 min). No demographic characteristics were found to influence the GE parameters. CONCLUSIONS: 13C-octanoic acid breath test determined by NDIRS is a simple, non-invasive and reliable measurement, which may provide an 'office-based' tool to detect solid GE.     

电阻抗断层成像与胃排空和胃动力检测

电阻抗断层成像(EIT)是继形态、结构成像之后,于近20余年发展,出现的新一代医学成像技术,具有功能成像,无损伤和医学图像监护三大突出优势.其在胃肠领域的最多应用是评价通过胃部的食物流动以替代临床仍然视为胃排空测量金标准的核素法.在离体的模型实验中EIT可精确测量玻璃棒/气囊的容积变化.在体实验条件下,EIT能精确测量胃容积(气囊)的变化.EIT胃排空测量与染料稀释法、胃存留法、核素法等有较好的相关性.EIT胃动力测量以置于体表的电极阵列实现无损检测,以实时图像方式直接显示体内胃体的收缩和运动状况,将是胃动力检测与评价手段的重大进步,显示了诱人的应用前景.     

Effect of age on gastric emptying of liquid-solid meals in man

A dual radioisotopic method was employed to study the rate of gastric emptying of meals in ten males with an average age of 31 years and 10 elderly males with an average age of 76.4 years. All study subjects were fed a standardized 900-g meal labeled with a liquid (111indium-DTPA) and solid (99mtechnetium-tagged liver) phase isotopic marker. There were no significant differences in solid food emptying rates between the young and aged men. A delay in liquid emptying, however, was observed in the aged men. The clinical significance of this observation is unknown.     

Variability of gastric emptying measurements in man employing standardized radiolabeled meals

Radiolabeled liquid and solid portions of standardized 300-g meals were administered on four different study days to eight healthy subjects in an attempt to define the range of inter- and intrasubject variability in gastric emptying. Meal half emptying times, analysis of variance, and intraclass correlations were computed and compared within and between subjects. The mean solid half emptying time was 58±17 min (range 29–92), while the mean liquid half emptying time was 24±8 min (range 12–37). A nested random effects analysis of variance showed moderate intrasubject variability for solid emptying and high intrasubject variability for liquid emptying. The variability of solid and liquid emptying was comparable and relatively large when compared with other reports in the literature. The isotopic method for measuring gastric emptying is a valuable tool for investigating problems in gastric pathophysiology, particularly when differences between groups of subjects are sought. However, meal emptying time is a variable phenomenon in healthy subjects with significant inter- and intraindividual day-to-day differences. These day-to-day variations in gastric emptying must be considered in interpreting individual study results.     

胃排空检测方法的研究进展

胃动力检查是诊断有消化道症状患者胃肠动力改变的重要检查方法,而胃排空检查是其中一个重要的项目。目前有多种胃排空检测方法在临床上应用,此文阐述了近年来胃排空功能检测方法的研究进展。     

Effects of hydrochlorides of amino acids in test meals on gastric emptying

Four subjects were given test meals containing various concentrations of hydrochlorides of glycine, alanine, arginine, phenylalanine and tryptophan. The gastric contents were recovered after 20 min. The volume of the original meal recovered was assessed from the amount of marker substance aspirated. It was found that the slowing of gastric emptying of amino acid hydrochlorides was consistent with their action as weak acids. However, tryptophan and phenylalanine were slightly more effective than was predicted on the basis of their actions as acids.     

Relation between gastric emptying of albumin-dextrose meals and cholecystokinin release in man

The effect of intragastric dextrose on albumin-stimulated cholecystokinin (CCK) release was studied in five healthy subjects and was related to gastric emptying and pancreatobiliary secretions. When combined with low concentrations of dextrose (4 g/100 ml), a 500-ml solution of albumin (7 g/100 ml) was rapidly emptied from the stomach into the duodenum (T1/2: 35 min). This rapid gastric emptying resulted in an only transient stimulation of pancreatobiliary secretion and an integrated CCK release of 278±45 pM × 180 min. When the concentration of dextrose in the albumin solution was increased from 4 g/100 ml to 21 g/100 ml, gastric emptying rate was distinctly slower (T1/2: 78 min;P<0.01) and pancreatobiliary secretions became sustained (P<0.01). CCK release was markedly higher (900±421 pM × 180 min;P<0.05) after ingestion of the solution containing a high dextrose concentration. Intraduodenal infusion of 21 g/100 ml dextrose (3.1 ml/min) failed to significantly stimulate plasma CCK levels (119±38 pM × 120 min). We suggest that the higher CCK release in response to intragastrically administered albumin solution containing high concentrations of dextrose may have been induced by augmented peptic digestion of albumin due to delayed gastric emptying and by increased enteral digestion of albumin due to increased pancreatobilary outputs.     

Gastric emptying of solid meals after truncal vagotomy and pyloroplasty in human subjects

Gastric emptying of isotopically labelled solid meals was studied in normal human subjects and in patients at different intervals after truncal vagotomy and Heineke-Mikulicz pyloroplasty.One to four weeks after vagotomy and pyloroplasty gastric emptying was delayed grossly in some patients regardless of the completeness of vagotomy. Patients with gross delay had symptoms of gastric retention. Eight weeks later emptying had returned towards normal and one or more years after vagotomy and pyloroplasty emptying was within the normal range.A subthreshold dose of carbachol injected during the course of emptying of a meal in some of the postvagotomy patients had no detectable influence on the rate of emptying of the meal.     

Applied potential tomography. A new noninvasive technique for measuring gastric emptying

Applied potential tomography is a new, noninvasive technique that yields sequential images of the resistivity of gastric contents after subjects have ingested a liquid or semisolid meal. This study validates the technique as a means of measuring gastric emptying. Experiments in vitro showed an excellent correlation between measurements of resistivity and either the square of the radius of a glass rod or the volume of water in a spherical balloon when both were placed in an oval tank containing saline. Altering the lateral position of the rod in the tank did not alter the values obtained. Images of abdominal resistivity were also directly correlated with the volume of air in a gastric balloon. Profiles of gastric emptying of liquid meals obtained using applied potential tomography were very similar to those obtained using scintigraphy or dye dilution techniques, provided that acid secretion was inhibited by cimetidine. Profiles of emptying of a mashed potato meal using applied potential tomography were also very similar to those obtained by scintigraphy. Measurements of the emptying of a liquid meal from the stomach were reproducible if acid secretion was inhibited by cimetidine. Thus, applied potential tomography is an accurate and reproducible method of measuring gastric emptying of liquids and particulate food. It is inexpensive, well tolerated, easy to use, and ideally suited for multiple studies in patients, even those who are pregnant.