WS1.6 The need of an appropriate diagnosis of gastroesophageal reflux disease in cystic fibrosis patients: impact on clinical management

Abstract

Objectives: The gastric emptying rate (GER) may be delayed in CF, but its assessment is problematic and previous CF studies have employed scintigraphic techniques which are expensive and unsuitable for routine use. We wished to assess the use of ultrasonography for this purpose, which has been validated in a non-CF population using a 3.5-MHz abdominal transducer probe measuring gastric antral size [1]. Methods: After an overnight fast, in the supine position we looked at 12 nondiabetic subjects (mean age 26 [SD 4] years, 9 male) comparing the GER in 8 pancreatic insufficient CF patients with 4 healthy controls. Subjects consumed 113mls (made up to 200mls with water) of Polycal®, a liquid energy supplement. Ultrasound measurements were made regularly over 2 hours and gastric emptying >63% at 90 minutes was considered normal. Results: There was a significant decrease in GER at 90 minutes (p = 0.04) and 120 minutes (p = 0.02) in the CF group (see table). Conclusions: Delayed gastric emptying occurs in pancreatic insufficient patients with CF and without known cystic-fibrosis related diabetes. The novel use of bedside ultrasound in this patient group will allow timely management of patients with gastro-paresis by dietary manipulation or prokinetic therapy.