Liquid gastric emptying is often abnormal when solid emptying is normal

Area of Science:

• Gastroenterology
• Nuclear Medicine
• Medical Imaging

Background:

• Medical literature suggests solid radionuclide gastric emptying studies are more sensitive than liquid studies for gastroparesis detection.
• Liquid studies are consequently rarely indicated in current medical practice.
• Institutional practice often involves referring patients for both solid and liquid gastric emptying studies.

Purpose of the Study:

• To review the results of both solid and liquid gastric emptying studies in patients referred for both.
• To prospectively investigate the relative diagnostic value of solid versus liquid gastric emptying studies.

Main Methods:

• A retrospective review of 21 patients who underwent both solid and liquid gastric emptying studies on separate days.
• A prospective investigation of 40 consecutive patients with gastroparesis symptoms, undergoing sequential solid and liquid studies on the same day.
• Determination of liquid emptying rate (T1/2) and solid percent emptying over 4 hours.

Main Results:

• In a retrospective review, 13 of 21 patients with normal solid emptying showed delayed liquid emptying.
• In a prospective study, 10 of 30 patients (33%) with normal solid emptying had delayed liquid emptying.
• Overall, 23% had delayed solid emptying and 32% had delayed liquid emptying.

Conclusions:

• Liquid gastric emptying is frequently abnormal in patients with normal solid gastric emptying studies.
• Routine performance of liquid gastric emptying studies in addition to solid studies is recommended for a complete evaluation of gastric motility.
• This approach is particularly important for patients presenting with symptoms suggestive of gastroparesis.