Assessment Of Gastric Accommodation Research Articles

Assessment of Gastric Accommodation in Patients with Functional Dyspepsia by 99mTc-Pertechtenate Single Photon Emission Computed Tomography Imaging: Practical but not Widely Accepted.

Objective:Impaired gastric accommodation is one of the main symptoms in patients with functional dyspepsia. The aim of the present study was to assess gastric accommodation in patients with functional dyspepsia using single photon emission computed tomography (SPECT) imaging.Methods:Twenty-four patients with functional dyspepsia and 50 healthy volunteers as control group were enrolled in this study. All participants were given 5 mCi 99mTc-pertechtenate intravenously, served with a low fat meal, and underwent SPECT scanning 20 minutes after the meal.Results:Based on the scintigraphic data, gastric volumes were found to be significantly increased after food ingestion in both patient and control groups. We also found that while there was no significant difference between patient and control groups in terms of fasting gastric volumes, postprandial gastric volume was significantly lower in patients as compared to healthy individuals (p<0.05).Conclusion:Measuring gastric volume by using SPECT can be a valuable method in the detection of functional dyspepsia and in differentiation of this entity from other organic disorders.

Sa1438 Usefulness of Gastric Scintigraphy in the Assessment of Gastric Accommodation

Background and Aims: Several studies have reported that gastric scintigraphy is a useful and non-invasive modality to assess the gastric motility, especially gastric emptying. Recently, many researchers have suggested that the measuring gastric emptying in addition to gastric accommodation is essential to evaluate gastric motility. Gastric accommodation is considered as postprandial relaxation of the proximal stomach. However, we have little knowledge of gastric scintigraphy to assess gastric accommodation. Accordingly, we aimed to clarify the usefulness of gastric scintigraphy in the assessment of gastric accommodation in comparison with gastric barostat which is a gold standard modality. Patients and Methods: Seventeen healthy volunteers (male/female 10/ 7; mean age 33.8 ± 10.5 years) were enrolled in this study. Test meal consisted of curry with rice; radiolabeled 99mTc (37 MBq) was used for scintigraphy. Volunteers ingested the test meal in the upright position with scintigraphic images recorded over time. Radioactivity in the upper-third andwhole stomachwas calculated to evaluate gastric accommodation. In the barostat procedure, a gastric balloon was inserted nasally and distended after a liquid meal ingestion (250 ml, 375 kcal). The maximal volume of distending balloon was measured to evaluate gastric accommodation. Thereafter, we investigated the correlation between scintigraphic and barostat accommodation. We next validated the reproducibility and intraand inter-observer variation for the scintigraphic test. Finally, we evaluated the diagnostic performance of scintigraphy using sumatriptan which delays gastric emptying and improves gastric accommodation as a positive control. The scintigraphic test was repeated in the same volunteers after one week. Data were evaluated by three investigators. Results: Accommodation measured with scintigraphy and barostat correrlated (r=0.524, p<0.05). For the scintigraphic test, sumatriptan significantly increased (51.5 ± 16.4 %) gastric accommodation compared with the control (38.4 ± 13.8 %) (p<0.01). Moreover, sumatriptan significantly delayed the gastric emptying (50 % half emptying time) at 60, 90, 120 and 150 min after the experimental start, respectively (p<0.05). The data obtained from repeated scintigraphic tests was highly reproducible (r=0.75) with significant differences observed among the investigators (r=0.90). Conclusions: Gastric scintigraphy is a useful modality to assess gastric accommodation and emptying.

Sa1441 Do Protease Inhibitors Influence Visceral Pain Sensitivity in Patients With Irritable Bowel Syndrome?

Background and Aims: Several studies have reported that gastric scintigraphy is a useful and non-invasive modality to assess the gastric motility, especially gastric emptying. Recently, many researchers have suggested that the measuring gastric emptying in addition to gastric accommodation is essential to evaluate gastric motility. Gastric accommodation is considered as postprandial relaxation of the proximal stomach. However, we have little knowledge of gastric scintigraphy to assess gastric accommodation. Accordingly, we aimed to clarify the usefulness of gastric scintigraphy in the assessment of gastric accommodation in comparison with gastric barostat which is a gold standard modality. Patients and Methods: Seventeen healthy volunteers (male/female 10/ 7; mean age 33.8 ± 10.5 years) were enrolled in this study. Test meal consisted of curry with rice; radiolabeled 99mTc (37 MBq) was used for scintigraphy. Volunteers ingested the test meal in the upright position with scintigraphic images recorded over time. Radioactivity in the upper-third andwhole stomachwas calculated to evaluate gastric accommodation. In the barostat procedure, a gastric balloon was inserted nasally and distended after a liquid meal ingestion (250 ml, 375 kcal). The maximal volume of distending balloon was measured to evaluate gastric accommodation. Thereafter, we investigated the correlation between scintigraphic and barostat accommodation. We next validated the reproducibility and intraand inter-observer variation for the scintigraphic test. Finally, we evaluated the diagnostic performance of scintigraphy using sumatriptan which delays gastric emptying and improves gastric accommodation as a positive control. The scintigraphic test was repeated in the same volunteers after one week. Data were evaluated by three investigators. Results: Accommodation measured with scintigraphy and barostat correrlated (r=0.524, p<0.05). For the scintigraphic test, sumatriptan significantly increased (51.5 ± 16.4 %) gastric accommodation compared with the control (38.4 ± 13.8 %) (p<0.01). Moreover, sumatriptan significantly delayed the gastric emptying (50 % half emptying time) at 60, 90, 120 and 150 min after the experimental start, respectively (p<0.05). The data obtained from repeated scintigraphic tests was highly reproducible (r=0.75) with significant differences observed among the investigators (r=0.90). Conclusions: Gastric scintigraphy is a useful modality to assess gastric accommodation and emptying.

Assessment of Gastric Accommodation by SPECT

Assessment of Gastric Accommodation by SPECT

Perfusion nutrient load test: a new method in assessment of gastric accommodation

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P 0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P 0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation. Key words: Stomach; Gastric accommodation; Liquid load test

1066 Perfusion Nutrition Load Test in Assessment of Gastric Accommodation and Sensitivity in Functional Dyspepsia Patients

1066 Perfusion Nutrition Load Test in Assessment of Gastric Accommodation and Sensitivity in Functional Dyspepsia Patients

S1067 Two Different Ways of Nutrition Load Test in Assessment of Gastric Accommodation in Health Subjects

S1067 Two Different Ways of Nutrition Load Test in Assessment of Gastric Accommodation in Health Subjects

Gastric Electrical Stimulation With Parameters for Gastroparesis Enhances Gastric Accommodation and Alleviates Distention-Induced Symptoms in Dogs

Gastric electrical stimulation (GES) improves symptoms in patients with gastroparesis. We sought to determine if stimulation at fundus with parameters used for gastroparesis could affect gastric accommodation and distention-induced symptoms in dogs. Nine dogs were implanted with a gastric cannula at the anterior stomach and 1 pair of stimulation electrodes in the fundus. Assessment of gastric accommodation and a series of gastric distention were performed using a barostat. Stimulation parameters were of short pulse trains of 14 Hz, 5 mA, 0.3 ms, and 0.1 s on, 5 s off. GES at fundus significantly decreased fasting gastric tone. Fasting gastric volume was significantly increased from 56.3+/-10.4 mL at baseline to 102.4+/-23.1 mL with stimulation (P=.011). Postprandial gastric accommodation was significantly enhanced with stimulation. The extent of accommodation increased from 249.3+/-39.9 mL in the control session to 325.8+/-25.1 mL with stimulation (P=.011). Symptom scores induced by balloon distention of the stomach were significantly lower during stimulation in comparison with those of baseline (P=.016). In conclusion, GES with parameters for gastroparesis enhances postprandial gastric accommodation and reduces visceral perception in normal dogs. This effect, if seen also in humans, may explain in part the symptomatic improvement associated with GES therapy in patients with gastroparesis.