Measurement of gastric accommodation: a reappraisal of conventional and emerging modalities

Impaired gastric accommodation is an important cause of functional dyspepsia. Currently available tests that evaluate gastric accommodation provide relevant physiological information, but they pose technical difficulties and their clinical impact remains controversial. Gastric barostat remains the gold standard, but it is an invasive procedure. In recent years, emerging modalities including single photon emission computed tomography (SPECT), three-dimensional ultrasound and magnetic resonance imaging have been developed to measure gastric volumes and hold promise as alternative methods of assessing gastric accommodation non-invasively. Studies are underway to validate these techniques with recent data proving the performance characteristics of SPECT. The non-invasive nutrient drink test measures satiety scores as a surrogate marker of gastric accommodation and remains controversial. More recently, intragastric monitoring has been proposed as yet another non-invasive modality to assess gastric accommodation. Each of these different modalities brings its associated advantages and disadvantages, as is discussed in this review. Ongoing studies to validate these new techniques are in progress and are likely to lead to further progress in neurogastroenterology.