Gastric Accommodation and Impact on Emptying of Solids in Gastroparesis

In healthy controls, higher gastric accommodation (GA) was associated with slower gastric emptying (GE) of solids.

In patients with gastroparesis: (1) To investigate the association between GA and GE of solids. (2) To assess the prevalence of abnormally high GA.

An electronic medical records (EMR) review (2010-2024) was conducted on 745 adult patients with measured GA following 300 kcal Ensure using SPECT, and scintigraphy-based GE of solids (320 kcal, 30% fat, egg meal). Among these patients, 284 had gastroparesis (GE < 25% emptied at 2 h or < 75% emptied at 4 h). Spearman correlation analysis examined associations between GA volume or ratio and GE at 1, 2, and 4 h, and GE T_1/2.

Weak positive correlations were observed between GA volume and GE of solids % at 1 and 2 h (respectively Rs = 0.148, p = 0.0234, and Rs = 0.121, p = 0.042). In addition, there was a correlation between GA ratio and GE of solids % at 2 h (Rs = 0.143, p = 0.0160). However, there were no significant correlations of GA with GE % at 4 h or GE T_1/2. Among the 284 patients with gastroparesis, we had documented increased GA, assessed by postprandial minus preprandial gastric volume (> 640 mL), in 7.75%, and increased GA by GA ratio > 3.85 in 22.9%.

Among patients with gastroparesis, higher GA is associated with accelerated GE of solids in the first 2 h, though the effect size is small. There is no significant effect on delayed GE at 4 h or GE T_1/2.