Abstract
2016 Objectives 60 minute (m) gastric residuals reflect the percentage of activity remaining in the stomach at 60m from the initial post feeding gastric activity. This method does not account for early gastric emptying that occurs during feeding. Gastric emptying studies in young children commonly employ a liquid, milk-based meal. Emptying begins during feeding with no lag phase. The effect of early emptying on quantitation of gastric emptying has been previously studied, but included children with medical problems that may influence the rate of gastric emptying. We investigated the impact of emptying that occurs during feeding of milk-based meals on the 60m gastric residuals in young children without medical conditions known to affect gastric motility. Methods 400 milk scans were reviewed retrospectively. All children were referred for the evaluation of GE reflux. 28 studies of children 2-37 months old, with no suspicion or predisposing conditions for gastric dysmotility and no GE reflux were selected. 60m gastric residuals from the initial gastric activity (Rg) were compared to 60m gastric residuals from the total ingested dose (Rtid). Rg was calculated by dividing gastric ROI counts at 60m by gastric ROI counts on the first image post feeding. Rtid was calculated by dividing the same gastric counts at 60m by the combined stomach and bowel ROI counts on the first image. Results Rtid was lower than Rg in all cases. The differences ranged from 4-31% with a median difference of 10%. The mean Rtid was 48% +/-18% and the mean Rg was 59% +/-20% (p=0.000004). Conclusions Significant emptying of milk-based meals occurs during the feeding period in young children without gastric motility disorders. The gastric residual from the total ingested dose accounts for this early emptying. Exclusion of early emptying may result in overestimated gastric residuals and should be recognized when establishing normal pediatric gastric emptying standards.
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