Gastric emptying and intestinal transit of pancreatic enzyme supplements in cystic fibrosis

Objective-To investigate gastric emptying and intestinal transit of pellete d pancreatin in relation to food boluses. Methods-Dual isotope scintigraphy combined with breath hydrogen sampling wa s used to track the concurrent gastric emptying and intestinal transit of ( 111)indium labelled microspheres and a (99m)technetium labelled tin colloid test meal. Twelve pancreatic insufficient cystic fibrosis patients aged 5 to 38 years performed the study. Results-50% gastric emptying times showed patient to patient variation. The mean discrepancy in 50% gastric emptying times between the two labels was > 67 minutes. Mean small bowel transit time for the food bolus was prolonge d at 3.6 minutes. A significant correlation was seen between weight standar d deviation score and 50% emptying time for pancreatin (r = +0.73). Conclusion-Gastric mixing of food and pancreatin may be limited by rapid em ptying of microspheres. Patients with high dosage requirements could benefi t from changing the pattern of their pancreatin supplementation.