Measurement of gastric emptying, intestinal transit time and colonic filling by scintiscan in healthy subjects

A scintigraphic technique allowing combined measurements of gastric emptying, small intestinal transit time and colonic filling was developed and its reproducibility assessed in 8 healthy volunteers. Each subject underwent four tests: a) two were performed in the fasting state (99mTc labelled water, added to lactulose), b) two in the postprandial state (balanced meal, 1,750 kJ, included pellets labelled with 111In, the gut transit of which being nearly the same as dietary fibers). Intestinal transit was modeled using linear operators (expressed as a convolution product). In fasting state (lactulose), orocecal transit time of water was 109 +/- 60 min and 89 +/- 36 min (m +/- DS) for the first and second tests, respectively. In the postprandial state, values were 297 +/- 37 min and 293 +/- 43 min respectively for the pellets. Small bowel transit times were 135 +/- 70 and 103 +/- 40 min respectively in fasting state for water, and 209 +/- 47 and 209 +/- 29 min respectively in postprandial state for the pellets. Determination of residual variance showed that reproducibility of the test was better in the postprandial state than in the fasting state. Water orocecal transit times measured using this technique and lactulose orocecal transit time measured using hydrogen breath test were strongly correlated (r = 0.98, n = 12, P less than 0.01). This isotopic method provides a reproducible assessment of gastric emptying, small bowel transit, and colonic filling and could represent a reliable and non invasive tool for further physiological and pharmacological studies.