Development of a test to measure gastric accommodation in humans

Postprandial symptoms of bloating, distension, early satiety, and nausea ar e associated with impaired postprandial gastric accommodation, which is det ectable by means of an intragastric, barostatically controlled balloon in t he proximal stomach and by ultrasound in the distal stomach. Our aim was to develop a noninvasive method to measure the entire gastric accommodation r eflex. In 10 healthy volunteers, we used single photon emission computed to mography (SPECT) to measure fasting and postprandial gastric volumes. This method involved intravenous injection of Tc-99m pertechnetate and gastric r econstruction of tomographic images with Analyze software. SPECT-Analyze im aging detects the postprandial gastric accommodation reflex in vivo. Mean f asting gastric volume was 182 +/- 11 (SE) ml and mean postprandial volume w as 690 +/- 32 mi (P < 0.001). Both proximal and distal segments of stomach showed a two- to almost fourfold difference in volumes postprandially. Intr aobserver coefficients of variation in estimated fasting and postprandial v olumes were 9 and 8%; interobserver variations were 13 and 12%, respectivel y. SPECT-Analyze noninvasively measures postprandial gastric (total, proxim al, and distal) accommodation in humans. This method appears promising to c ompare the accommodation response in health and disease and to perform mech anistic studies of the accommodation response.