Delay of gastric emptying by duodenal intubation: sensitive measurement ofgastric emptying by the paracetamol absorption test

Aims: To examine the influence of duodenal intubation on gastric emptying m easured by the paracetamol absorption test using a new algorithm developed to estimate emptying parameters, and to determine the sensitivity of this t est. Methods: A caloric liquid meal with paracetamol as marker of emptying was a dministered orally to eight healthy volunteers during phase I and phase II of the migrating motor complex (MMC) and without intubation on 3 separate d ays, and to 10 patients with partial gastrectomy. Results: Healthy subjects: With duodenal tube, time until 25% of the meal h ad emptied (t(25%)) was 24 +/- 7 (phase I, P < 0.02) and 21 +/- 6 min (phas e II, P < 0.02) compared with 14 +/- 4 min for meal intake without intubati on, Time until 50% of the meal had emptied (t(50%)) was 45 +/- 8 (phase I, P < 0.001) and 35 +/- 8 min (phase II, P < 0.02) compared with 26 +/- 9 min for meal intake without intubation, Intraduodenal instillation of 10-20 mt of the liquid meal was reliably detected. Patients: In 9 out of 10 patients with partial gastrectomy t(25%) was below the lower limit of the range for healthy controls, and t(25%) detected acc elerated emptying with a higher degree of sensitivity than the commonly app lied pharmacokinetic parameters C-max and T-max. Conclusions: A duodenal tube delays gastric emptying of a caloric liquid me al. The paracetamol absorption test emerges as a sensitive method suitable for detecting both delayed and accelerated gastric emptying of caloric liqu id meals.