Assessment of gastric emptying - Comparison of solid scintigraphic emptying and emptying of radiopaque markers in patients and healthy subjects

The gold standard for measuring gastric emptying is scintigraphy, either wi th digestible solids or liquids. Unfortunately, this method is expensive an d of limited availability. An alternative could be to use radiopaque marker s (ROMs). Our aim was to compare these two tests in healthy volunteers and in patients to see whether emptying of ROMs can substitute for scintigraphi c solid emptying. We also intended to see if patients with small intestinal bacterial overgrowth (SIBO) had delayed gastric emptying. Twenty healthy s ubjects and 21 patients, 11 with SIBO and 10 with insulin-dependent diabete s mellitus (IDDM), were included. A standard meal with a [Tc-99m]MAA-labele d omelet and 20 ROMs was given. Scintigraphic emptying and ROM emptying wer e followed simultaneously. Reference values for gastric emptying of ROMs we re determined in 50 healthy subjects. The scintigraphic method and the radi ologic method correlated significantly in healthy subjects (P < 0.05), and in patients (P < 0.001), when comparing half-emptying time for both methods . Scintigraphic half-emptying time correlated significantly with emptying o f ROMs after 6 hr. Six of 11 patients with SIBO (P < 0.02) and 7/10 patient s with IDDM (P < 0.02) had delayed scintigraphic emptying of solids using t he 95th percentile in the controls as the upper reference value. Gastric em ptying of ROMs was, similar to solid scintigraphic gastric emptying, slower in women than in men. In conclusion, scintigraphic emptying of solids and emptying of ROMs are closely correlated. The radiologic method can be used as a simpler and more readily available method. Women have slower gastric e mptying of ROMs than men, which necessitates separate reference values. A h igh proportion of patients with symptomatic IDDM and with SIBO have delayed gastric emptying.