32 How common is rapid gastric emptying in gastroparesis? Comparison of area under the curve, total gastric emptying and 1‐hour values in patients and normal volunteers

Abstract

Introduction: Rapid gastric emptying has been described not only in patients with nausea and vomiting and gastroparesis but also in obesity and dyspepsia. We investigated the use of three measures of rapid gastric emptying in a large group of patients with gastroparesis as compared to normal controls.Patients: From a pool of 214 consecutive patients with the symptoms of gastroparesis we reviewed the results of standardized solid gastric emptying tests and compared the results to a group of normal controls as previously described (AJG 95: 1456‐14622000). Patients were 39 males, 175 females mean age 42 years, with diagnosis of 42 Diabetes Mellitus, 26 Post Surgical and 146 Idiopathic diseases.Methods: Gastric emptying was compared by three models: Area under the emptying curve (AUC, rapid < 0.257), total gastric emptying (TGE: the sum of 1, 2 and 4 hours; rapid < 47), and percentage remaining at 1 hour (<37%) for rapid and/or at 4 hours (>10%) for delayed emptying, using data and techniques previously described (AGJ2004; 99: S45 and NGM 2005; 17: 470).Results: Measurable gastric emptying could be determined for 4 hours emptying in 146 patients; 87 patients had complete 1, 2 and 4 hours emptying. 44 patients had delayed emptying by 4 hour% >10%, seven patients (8%) had rapid gastric emptying by AUC and eight pts (9%) had rapid emptying by the TGE values; and 16 (18%) pts had rapid emptying by the 1 hour value alone.Conclusion: Rapid gastric emptying of a solid meal is not uncommon in patients with the symptoms of gastroparesis. The AUC and TGE models identified approximately the same number of patients with rapid emptying, while the 1‐hour model identified approximately twice as many patients. Using the three techniques described to determine rapid gastric emptying awaits prospective use in other patients, including dyspepsia and obesity. Standardized measure for rapid gastric emptying may be useful in evaluating therapeutic outcomes for these disorders.