Solid Meal Research Articles

Effect of Rikkunshito, a Chinese Herbal Medicine, on Stasis in Patients After Pylorus‐Preserving Gastrectomy

Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) have been employed for gastric cancer, with PPG having been reported to be superior to DG in regard to postoperative quality of life. Some patients with these operations still suffer from gastric stasis, however. In this study, we aimed to examine the clinical effects of rikkunshito on patients who were to undergo PPG. A total of 11 patients who were scheduled to undergo PPG for early gastric cancer at the Osaka University Hospital were enrolled. The patients were randomly assigned to the crossover study with and without rikkunshito 7.5 g/day. Questionnaires and emptying tests using (111)In-labeled liquid scintigraphy and (99m)Tc-labeled solid scintigraphy were performed at the end of each treatment period. Stasis-related symptoms were significantly reduced during rikkunshito treatment (p = 0.043). The emptying test showed that rikkunshito improved emptying of solid meals (p = 0.0003) from the remnant stomach but did not accelerate gastric empting of liquid meals. Rikkunshito improved gastric emptying and ameliorated postoperative symptoms of patients who had undergone a PPG.

Severe benign esophageal stricture following postoperative emesis

An 80-year-old man presented with dysphagia after surgery for a hepatic tumor. In the postoperative period, he suffered from emesis and thereafter experienced dysphagia when taking a solid meal. The cause of his dysphagia was a benign lower esophageal stricture that had not been detected during preoperative examinations. Conservative treatment involving balloon dilatation was not effective, and the patient finally underwent a lower esophagectomy with reconstruction of the jejunum interposition from a left thoraco-abdominal approach. Based on his clinical manifestations, pathological findings, and published reports, we suggested that he suffered an incomplete esophageal perforation after emesis that led to esophageal stricture as a result of fibrosis of the esophageal wall. This rare case demonstrates that an esophageal injury caused by postoperative emesis can result in a benign esophageal stricture.

Weight Loss After Laparoscopic Adjustable Gastric Banding is not Caused by Altered Gastric Emptying

In order to know the role of gastric emptying in the mechanism of weight loss and early satiety after a restrictive surgical procedure for treatment of morbid obesity, a consecutive series of patients were scintigraphically investigated before and after laparoscopic adjustable gastric banding. Sixteen patients undergoing laparoscopic adjustable gastric banding underwent preoperatively, and at 6 months postoperatively, a gastric emptying study (solid meal and single isotope). Esophageal retention time, lag phase, peak activity time, gastric emptying rate, fundus emptying rate, and weight loss were recorded. Upper GI symptom assessment was carried out by using a standardized questionnaire. Gastric emptying parameters were correlated with the upper GI symptoms. Gastric band placement showed no significant influence on postoperative gastric emptying rate [median % (interquartile range): 42 (23.3-59) preoperatively vs 38 (31-71) postoperatively and fundus emptying rate: 59(37-91) preoperatively vs 70 (53-89) postoperatively]; however, an increase in early satiety was found. Neither gastric emptying rate nor fundus emptying rate showed a relation with early satiety or weight loss. Furthermore, no correlation was found between early satiety and lag phase, esophageal retention time, start of activity, and peak activity time in proximal stomach. Laparoscopic adjustable gastric banding seems not to affect gastric emptying. Neither a relation between postoperative gastric emptying rate and weight loss nor between early satiety and weight loss was found. Therefore, it is unlikely that gastric emptying plays a role in the mechanism of weight loss following laparoscopic adjustable gastric banding.

Effect of a Cellulose‐containing Weight‐loss Supplement on Gastric Emptying and Sensory Functions

CM3, a highly cross-linked cellulose in capsule form, expands in the stomach to a size several fold of its original volume. It is purported to induce a prolonged feeling of satiation and a delay in gastric emptying, thus promoting weight loss. We examined whether CM3 delays gastric emptying (using the stable isotope (13)C-octanoic breath test) and whether it influences subjective feelings of appetite sensations (using visual analog scales, VASs). We performed a double-blind randomized placebo-controlled crossover trial in 19 moderately obese but otherwise healthy subjects (mean age 55 +/- 9 years, BMI 31.1 +/- 4.6 kg/m(2)). The subjects were treated with six capsules of CM3 or matching placebo 30 min before a standardized solid meal. Breath collection and VASs were performed over 4 h every 15 min and 30 min, respectively. Half-excretion time of (13)CO(2) in breath, indicating gastric emptying half time, was the primary outcome parameter. The study was powered to detect a change in gastric emptying of 20-30 min. Mean (13)CO(2) half-excretion time changed from 2.3 +/- 0.4 to 2.4 +/- 0.33 h (mean difference +6 min, 95% confidence interval (CI) -3 to +15 min; P = 0.17). Appetite sensations (hunger, satiation, fullness, prospective food consumption, desire to eat something sweet, salty, savory, or fatty) changed over time during the course of the postprandial phase but were not influenced by CM3 (repeated measures ANOVA). In obese subjects, acute administration of the weight-loss supplement CM3 does not delay gastric emptying and does not influence subjective appetite sensations.

Gastric motility evaluated by electrogastrography and alternating current biosusceptometry in dogs

Association techniques could be the answer for evaluating electromechanical coupling and gastric emptying under basal conditions and after administration of drugs. Electrogastrography (EGG) and alternating current biosusceptometry (ACB) emerged due to their interesting nature, noninvasiveness and low cost. The aims were to examine in dogs the effect of erythromycin on gastric emptying by ACB and electrical and motor responses to erythromycin and propranolol by ACB and EGG respectively. Twelve beagle dogs ingested a solid test meal on separate days. Under anesthesia, gastric motility was evaluated by EGG and ACB after erythromycin and propranolol administration. Without anesthesia, gastric emptying was assessed under basal conditions and after erythromycin by ACB. ACB and EGG showed a strong temporal correlation. Erythromycin and propranolol presented the same profile with different power ratios; the amplitude increased whereas frequency decreased. Also, erythromycin administration hastened gastric emptying while reducing the orocaecal transit time. There is a demand for reliable, easy-to-perform and comfortable techniques to record gastric emptying and gastric activity in medicine and veterinary practice. In summary, the association of ACB with EGG accompanied by an appropriate animal model is promising for evaluating effects of drugs in gastric myoelectrical and contractile activity.

Long-term effects of lipase inhibition by orlistat on gastric emptying and orocecal transit time of a solid meal

We assessed the impact of a prolonged lipase inhibition upon gastric emptying (GE) and orocecal transit time (OCTT) of a 355-kcal low-fat solid meal. In double-blind manner, 40 obese women BMI > 30 kg/m2, randomly allocated into two equal groups, took orally t.i.d. 120 mg orlistat or placebo during 8 weeks of a weight-reducing management. At randomization and after 2 months, GE was measured simultaneously with OCTT by means of a 13C-octanoic acid and a hydrogen breath test, respectively. Lipolytic activity was evaluated with a 13C-mixed triglyceride breath test (13C-MTGBT). A profound lipase inhibition by orlistat was confirmed by a 79.5% +/- 16.9% reduction of the cumulative 6-h 13C recovery with 13CMTGBT. GE remained unchanged either in the orlistat (T1/2, 188 +/- 35 min start versus 198 +/- 36 min end) or the placebo (T1/2, 191 +/- 35 min start versus 180 +/- 39 min end) group. OCTT increased from 208 +/- 54 min to 271 +/- 64 min (P < 0.01) after orlistat treatment and did not change significantly (216 +/- 76 vs. 234 +/- 72 min) in the placebo group. No adverse effect on the GE and a moderate prolongation of the OCTT of a low-fat solid meal is to be expected under a prolonged treatment with orlistat at a typical dosage regimen.

Effect of exenatide on gastric emptying and relationship to postprandial glycemia in type 2 diabetes

Objectives To evaluate the effect of exenatide on gastric emptying (GE) in type 2 diabetes using scintigraphy. Methods Seventeen subjects with type 2 diabetes participated in a randomized, single-blind, 3-period, crossover study. In each 5-day period, 5 or 10 µg exenatide or placebo was administered subcutaneously BID. Oral antidiabetic treatments were continued. The presence of cardiac autonomic neuropathy was assessed during screening. On day 5, after the morning dose, subjects consumed a 450-kcal breakfast containing 99mTc-labeled eggs and 111In-labeled water, and GE was measured by scintigraphy. Plasma glucose and insulin, perceptions of appetite, and plasma exenatide were also quantified. Results Exenatide slowed GE of both solid and liquid meal components [solid ( T 50(90% confidence interval [CI]); placebo, 60(50–70) min; 5 µg exenatide, 111(94–132) min; 10 µg exenatide, 169(143–201) min; both P < 0.01); liquid ( T 50(90% CI), placebo, 34(25–46) min; 5 µg exenatide, 87(65–117) min; 10 µg exenatide, 114(85–154) min; both P < 0.01)]. GE was not different between subjects with cardiac autonomic neuropathy ( n = 7), compared with those without ( n = 10) ( P ≥ 0.68). Exenatide reduced postprandial glucose (area under the curve [AUC (0–6 h)]) by 69–76% and peak insulin ( C max) by 84–86% compared with placebo. There was an inverse relationship between the postprandial rise in glucose (AUC (0–3 h)) and GE (solid T 50, r = − 0.49, P < 0.001). Conclusions Exenatide slows GE substantially in type 2 diabetes, which could be an important mechanism contributing to the beneficial effect of exenatide on postprandial glycemia.

Liquid and Solid Meal Replacement Products Differentially Affect Postprandial Appetite and Food Intake in Older Adults

Liquid and solid foods are documented to elicit differential appetitive and food intake responses. This study was designed to assess the influences of liquid vs solid meal replacement products on postprandial appetite ratings and subsequent food intake in healthy older adults. This study used a randomized and crossover design with two 1-day trials (1 week between trials), and 24 adults (12 men and 12 women) aged 50 to 80 years with body mass index (calculated as kg/m 2) between 22 and 30 participated. After an overnight fast, the subjects consumed meal replacement products as either a beverage (liquid) or a bar (solid). The meal replacement products provided 25% of each subject's daily estimated energy needs with comparable macronutrient compositions. Subjects rated their appetite on a 100 mm quasilogarithmic visual analog scale before and 15, 30, 45, 60, 90, 120, and 150 minutes after consuming the meal replacement product. At minute 120, each subject consumed cooked oatmeal ad libitum to a “comfortable level of fullness.” Postprandial composite (area under the curve from minute 15 to minute 120) hunger was higher ( P=0.04) for the liquid vs solid meal replacement products and desire to eat ( P=0.15), preoccupation with thoughts of food ( P=0.07), and fullness ( P=0.25) did not differ for the liquid vs solid meal replacement products. On average, the subjects consumed 13.4% more oatmeal after the liquid vs solid ( P=0.006) meal replacement product. These results indicate that meal replacement products in liquid and solid form do not elicit comparable appetitive and ingestive behavior responses and that meal replacement products in liquid form blunt the postprandial decline in hunger and increase subsequent food intake in older adults.

Ultrasonographic evaluation of gallbladder dysfunction in patients with functional dyspepsia

The study aims to observe the gallbladder emptying in patients with functional dyspepsia, by means of ultrasonographic method described by Dodd et al. We measured the corelation between symptoms and presence of gallbladder dysfunction after a solid meal. Study also aims to evaluate the influence of Helicobacter pylori infection on gallbladder motility. Gallbladder and gastric evacuation were analized for identiffication of coordination problems between gastric and biliary motility.

Ultrasound measurement of gastric emptying of a solid test meal. Correlation with scintigraphy in diabetic patients and reproducibility in healthy probands

Measurement of gastric emptying of liquids by sagittal antral planimetry is established. Ultrasonic measurement of gastric emptying of solids has not been assessed although gastroparesis often reveals a delayed gastric emptying of solids first. Therefore in this prospective study we used a solid meal (50 g rye bread, 1 egg, 40 g butter, 200 ml orange juice; 280 kcal) to examine intraindividual reproducibility of ultrasound in 20 healthy volunteers. Moreover, in 20 diabetics antral planimetry assessed by ultrasound was compared to scintigraphy. Antral planimetry showed a coefficient of variation, that was nearly three times greater between subjects than between two measurements performed on the same subject. This results reflect a good intraindividual reproducibility. Gastric emptying half-times assessed by ultrasound and scintigraphy did not correlate in diabetics (R = 0.2). However, correlation between sonographic measurement of antral area and scintigraphy at defined times (60, 120, 180, 240 min) was significant (R = 0.7; p < 0.001). These results imply that ultrasonic antral planimetry is a suitable orientating method for measuring gastric emptying of solids.

Glycemic Index Reduction by a Viscous Polysaccharide Blend Independent of Food Form: Determination of the Glycemic Reduction Index Potential (GRIP)

Objectives: To determine the extent to which a novel viscous polysaccharide blend (VPB), reduces post prandial glycemia and the glycemic index (GI) when added to either a liquid or a solid meal. VPB is commercially known as PGXTM.Methods: Two groups of 10 healthy subjects (5M, 5F; age, 35.6 ± 13.2 y; BMI 24.6 ± 2.1 kg/m2; and 3M, 7F; age, 33.5 ± 11.1y; BMI 26.3 ± 5.2 kg/m2), participated in an acute randomized controlled study. Zero, 2.5, 5 and 7.5 g of VPB was added to either a glucose drink or white bread (WB) and margarine (Marg). All meals contained 50g of available carbohydrate. Capillary blood samples were taken fasting and at 15, 30, 45, 60, 90 and 120 min after the start of the meal. Control meals (glucose or WB) were repeated 3 times.Results: Addition of VPB to glucose and white bread significantly reduced blood glucose iAUC irrespective of dose (p&lt;0.01). The GI of glucose alone, and glucose and 2.5g, 5g or 7.5g were 100, 84, 78 and 73 respectively, the GI of the white bread, WB+Marg, WB and 2.5, 5g or 7.5g of VPB were 71, 67, 48, 37, and 34 respectively. The Glycemic Reduction Index Potential (GRIP) per g of VPB was 4.9±0.9 with glucose and 7.0±1.3 GI units with WB.Conclusion: The novel viscous fiber blend, is highly effective in lowering the glycemic index of a food irrespective of food form. Estimated GRIP for the VPB was 5 units when added to liquid and 7 units when added to a solid food.Sponsor: InovoBiologic, Inc, Calgary

Increasing habitual protein intake results in reduced postprandial efficiency of peripheral, anabolic wheat protein nitrogen use in humans

Background: The postprandial retention of dietary protein decreases when the prevailing protein intake increases.Objective: We investigated the influence of the prevailing protein intake on the regional utilization and anabolic use of wheat protein during the postprandial non–steady state in humans.Design: Healthy adults (n = 8) were adapted for 7 d, first to a normal-protein diet (NP: 1 g · kg−1 · d−1) and then to a high-protein diet (HP: 2 g · kg−1 · d−1). After each adaptation period, the subjects received the same single, solid mixed meal containing [15N]-labeled wheat protein. The postprandial kinetics of dietary nitrogen were then measured for 8 h in blood and urine. These data were further analyzed by using a multicompartmental model to predict the postprandial kinetics of dietary nitrogen in unsampled pools.Results: The postprandial whole-body retention of wheat protein nitrogen, measured 8 h after meal ingestion, decreased by 10% when the subjects switched from the NP diet to the HP diet. According to modeling results, this resulted from an increased splanchnic utilization of dietary nitrogen for urea production, whereas its incorporation into splanchnic proteins was unchanged, leading to a 20–30% decrease in peripheral availability and anabolic use in HP-adapted compared with NP-adapted subjects having ingested the same protein load.Conclusions: By combining clinical experimentation with compartmental modeling, we provide a global overview of postprandial dietary protein metabolism. Increasing prior protein intake was shown to reduce the postprandial retention of wheat protein nitrogen, mainly by diminishing the efficiency of its peripheral availability and anabolic use.

Effect of chewing and taste on splanchnic blood flow

To investigate the each role of chewing and taste in the control of splanchnic blood flow, which reportedly increased at initial phase of meal, we compared the blood flow responses in celiac artery (CA) to chewing of solid meal (MEAL, with chocolate taste) and paraffin wax (WAX, without taste). After five minutes of baseline measurement, twelve healthy subjects repeated chewing and expectorating the MEAL or WAX for 4 minutes followed by 10 minutes of recovery measurement. We measured blood velocity (BV) in CA and masseteric electromyogram (EMG). The BV in CA at the baseline and the masseteric EMG during chewing were not different between MEAL and WAX trials. The BV in CA significantly decreased at the 1st minute of chewing from the baseline in both trials. In the MEAL trial the BV in CA significantly increased at the 3rd minute of chewing from the baseline, whereas in the WAX trial the BV in CA returned to the baseline value. The BV in CA was significantly higher in the MEAL trial than the WAX trial at the 3rd minute of and after chewing. These results suggest that the taste of food plays a role in meal‐induced splanchnic hyperemia.

Small particle size of a solid meal increases gastric emptying and late postprandial glycaemic response in diabetic subjects with gastroparesis

Our goal was to investigate if food of small particle size increases the gastric emptying rate and lessens the fall in postprandial blood glucose in seven subjects with Type 1 diabetes and gastroparesis. Two solid meals of identical composition but of different particle size, with 5 MBq 99mTc added to the meals, were ingested in randomized order in seven subjects with Type 1 Diabetes Mellitus and gastroparesis and seven healthy subjects. During 180 min blood glucose and insulin concentrations were measured and gastric emptying of the ingested meals was registered by a gamma camera. The lag phase in the stomach was significantly shorter, the radioactivity remaining in the stomach after 120 min ( T 120) was significant less and the postprandial blood glucose dip was less and of shorter duration after a small particle (SP) meal, compared to a large particle (LP) meal in diabetic subjects. Gastric emptying did not differ significantly between groups after an SP meal. Food of small particle size increases the gastric emptying rate and reduces the postprandial blood glucose dip in both magnitude and duration in Type 1 diabetic subjects with gastroparesis, which is likely to be of importance in achieving good metabolic control.

A randomized, placebo‐controlled, crossover, double‐blind trial of the NK1 receptor antagonist aprepitant on gastrointestinal motor function in healthy humans

Little is known about the role of tachykinins on human gastrointestinal motility and no data exist on the possible effect of an NK1 receptor antagonist. To examine the effect of an antiemetic dose of the selective NK1 receptor antagonist aprepitant on gastrointestinal propulsion in healthy humans. Twelve healthy volunteers participated in a crossover, double-blind study. In random order, each volunteer had a 125-mg capsule of aprepitant or placebo on day 1 followed by an 80-mg capsule of aprepitant or placebo on days 2-5. Gamma camera imaging was used to measure gastric emptying, small intestinal transit and colonic transit of a radiolabelled, 1600-kJ mixed liquid and solid meal ingested on day 2. Aprepitant did not change gastric retention at 15 min, gastric half emptying time, gastric mean transit time, time to small intestinal transit of 10%, small intestinal mean transit time or colonic geometric centre after 24, 48 and 72 h. A 125-mg capsule of aprepitant followed by an 80-mg capsule of aprepitant each of the next 2-5 days did not induce major changes in the propulsive function of the gastrointestinal tract in the small number of healthy volunteers investigated.

Gastric emptying of a non‐digestible solid: assessment with simultaneous SmartPill pH and pressure capsule, antroduodenal manometry, gastric emptying scintigraphy

Gastric emptying of digestible solids occurs after trituration of food particles. Non-digestible solids are thought to empty with phase III of the migrating motor complex (MMC). The aim of this study was to determine if a non-digestible capsule given with a meal empties from the stomach with return of the fasting phase III MMC or during the fed pattern with the solid meal. Fifteen normal subjects underwent antroduodenal manometry and ingestion of a radiolabelled meal and SmartPill wireless pH and pressure capsule. In five subjects, emptying of the SmartPill was studied in the fasting period by ingesting the SmartPill with radiolabelled water. The SmartPill emptied from the stomach within 6 h in 14 of 15 subjects. SmartPill pressure recordings showed high amplitude phasic contractions prior to emptying. SmartPill gastric residence time (261 +/- 22 min) correlated strongly with time to the first phase III MMC (239 +/- 23 min; r = 0.813; P < 0.01) and correlated moderately with solid-phase gastric emptying (r = 0.606 with T-50% and r = 0.565 with T-90%). Nine of 14 subjects emptied the capsule with a phase III MMC. In five subjects, the SmartPill emptied with isolated distal antral contractions. In five subjects ingesting only water, SmartPill gastric residence time (92 +/- 44 min) correlated with the time to the first phase III MMC (87 +/- 30 min; r = 0.979; P < 0.01). The non-digestible SmartPill given with a meal primarily empties from the stomach with the return of phase III MMCs occurring after emptying the solid-phase meal. However, in some subjects, the SmartPill emptied with isolated antral contractions, an unappreciated mechanism for emptying of a non-digestible solid.

The utility of noninvasive 13C-acetate breath test using a new solid test meal to measure gastric emptying in mice

In clinical and experimental settings, the (13)C breath test is performed to measure gastric emptying and has advantages of noninvasiveness and repeatability. We intended to apply the (13)C breath test method to mice with an easy-to-handle solid test meal that is more physiological than liquid meals. Male ddY mice were trained to eat (13)C-acetate-containing pellets as the solid test meal. Thirty minutes after administration of metoclopramide (0.3-3 mg/kg, p.o.) or atropine sulfate (0.3-3 mg/kg, i.p.), mice received the test meal and were placed in chambers. The (13)CO(2) levels in the expired air were measured and the maximum concentration (C(max); per thousand) and the time to reach the maximum concentration (T(max); min) were determined. Metoclopramide significantly and dose-dependently increased C(max) and decreased T(max). On the other hand, atropine sulfate significantly and dose-dependently decreased C(max) and increased T(max). The (13)C-acetate breath test using a solid test meal is sensitive enough to detect both enhanced and delayed gastric emptying of the reference drugs.

Étifoxine : pharmacologie comportementale

Etifoxine, a benzodiazepine anxiolytic, exerts an autonomic regulatory activity. Two clinical studies have shown that etifoxine is effective in the treatment of adjustment disorder with anxiety. In view of the diversity of disorders associated with anxiety, with or without various autonomic manifestations, we were interested in the behavioural effects of etifoxine in animal models, particularly when animals exposed to stressful stimuli exhibit exaggerated autonomic signs other than those of cardiovascular origin. The effects of etifoxine were first evaluated in a stress-induced hyperthermia model in the rat. Manipulation of this animal causes an elevation of rectal temperature corresponding to a state of anticipatory anxiety. Again in the rat, etifoxine was evaluated in a conditioned fear test during which a more stressful stimulus constituted by the presentation of unavoidable, unpleasant electric shocks was applied. Behavioural blockade or freezing in response to this stress and the amplitude of colonic motor activity quantified by recording myoelectrical activity were measured. Subsequently, given the importance of the role played by corticoliberin or CRF, a hypothalamic neurohormone and/or neurotransmitter, in the co-ordination and mediation of autonomic responses to stress, we used a mouse model in which intracerebral administration of CRF mimics a major stress state, evidenced by a reduction in gastric emptying of a solid meal. The effects of etifoxine were evaluated in this model. A benzodiazepine (bromazepam or diazepam) was chosen as a positive control in each experiment. The elevation of rectal temperature following manipulation is significantly reduced in the presence of etifoxine (50 mg/kg). Likewise, etifoxine significantly and dose-dependently (12.5-50 mg/kg) reduces the duration of behavioural blockade or freezing following the application of unavoidable electric shocks. At the same time, the same stimulus causes an increase in the number of myoelectrical signals in the colon, which are significantly reduced by etifoxine. In the mouse, centrally administered CRF (0.35 μg/animal) reduces gastric emptying of a solid meal. This effect of CRF is dose-dependently antagonised by etifoxine. This series of results shows that etifoxine reduces the amplitude of autonomic manifestations in response to a stressful stimulus of variable intensity, such as hyperthermia, increased colonic motor activity or reduced gastric emptying. The anxiolytic properties of etifoxine are therefore exerted on both the behavioural and the autonomic aspects. These results provide a basis for evaluating this drug in anxious patients in whom autonomic nervous system manifestations constitute pathological symptoms.

Effect of a cross-linked cellulose-containing weight-loss supplement on gastric emptying and sensory functions in obese subjects

Aims: CM3, a weight-loss supplement consisting of highly cross-linked cellulose, is applied in a capsule-form and expands in the stomach to a size up to 18-fold of its original. It is advertised as inducing an immediate feeling of satiety and delaying gastric emptying, thus supporting weight loss management. Its putative mechanism of action is unclear. Purpose of the study was to examine if CM3 delays gastric emptying (using the stable isotope 13C octanoic breath test) and influences subjective feelings of appetite sensations (using anchored visual analogue scales, VAS) after a standardized solid meal.

Prevalence and determinants of delayed gastric emptying in hospitalised Type 2 diabetic patients

To determine the prevalence of delayed gastric emptying (GE) in older patients with Type 2 diabetes mellitus. One hundred and forty seven patients with Type 2 diabetes, of whom 140 had been hospitalised, mean age 62.3 +/- 8.0 years, HbA1c 9.1% +/- 1.9%, treated with either oral hypoglycemic drugs or insulin were studied. GE of a solid meal (scintigraphy), autonomic nerve function, upper gastrointestinal symptoms, acute and chronic glycemic control were evaluated. Gastric emptying results were compared to a control range of hospitalised patients who did not have diabetes. Gastric emptying was delayed (T50 > 85 min) in 17.7% patients. Mean gastric emptying was slower in females (T50 72.1 +/- 72.1 min vs 56.9 +/- 68.1 min, P = 0.02) and in those reporting nausea (112.3 +/- 67.3 vs 62.7 +/- 70.0 min, P < 0.01) and early satiety (114.0 +/- 135.2 vs 61.1 +/- 62.6 min, P = 0.02). There was no correlation between GE with age, body weight, duration of diabetes, neuropathy, current glycemia or the total score for upper gastrointestinal symptoms. Prolonged GE occurs in about 20% of hospitalised elderly patients with Type 2 diabetes when compared to hospitalised patients who do not have diabetes. Female gender, nausea and early satiety are associated with higher probability of delayed GE.