Total Gastric Emptying Time Research Articles

Effect of gum chewing on gastric volume and emptying: a prospective randomized crossover study

BackgroundCurrent fasting guidelines allow oral intake of water up to 2 h before induction of anaesthesia. We assessed whether gum chewing affects gastric emptying of 250 ml water and residual gastric fluid volume measured 2 h after ingestion of water. MethodsThis prospective randomized observer-blind crossover trial was performed on 20 healthy volunteers who attended two separate study sessions: Control and Chewing gum (chlorophyll flavour, with 2.1 g carbohydrate). Each session started with an ultrasound measurement of the antral area, followed by drinking 250 ml water. Then, volunteers either chewed a sugared gum for 45 min (Chewing gum) or did not (Control). Serial measurements of the antral area were performed during 120 min, and the half-time to gastric emptying (t½), total gastric emptying time, and gastric fluid volume before ingestion of water and 120 min later were calculated. ResultsGastric emptying of water was not different between sessions; the mean (sdsd) t½ was 23 (10) min in the Control session and 21 (7) min in the Chewing gum session (P=0.52). There was no significant difference between sessions in gastric fluid volumes measured before ingestion of water and 120 min later. ConclusionsChewing gum does not affect gastric emptying of water and does not change gastric fluid volume measured 2 h after ingestion of water. Clinical trial registrationNCT02673307.

The superiority of paracostal endoscopic-assisted gastropexy over open incisional and belt loop gastropexy in dogs: a comparison of three prophylactic techniques.

Prophylactic gastropexy is a procedure that prevents the occurrence of a life threatening condition known as gastric dilation and volvulus (GDV) in dogs. The objective of this study was to compare incisional, belt loop and minimally invasive endoscopically assisted gastropexy by evaluating different parameters such as surgical time, length of scar and score of pain in dogs. Twenty-one healthy, mixed-breed adult dogs weighting 14.3 ± 2.6 kg were randomly divided into three groups. Three gastropexy techniques applied in the following order: incisional (group I), belt loop (group B), and endoscopically assisted gastropexy (group E). Surgical time, anesthetic time, length of surgical incision and score of pain 3 h after surgery were recorded for all dogs. Two weeks after the surgery, positive-contrast gastrography was used to evaluate stomach position and total gastric emptying time. Ultrasonography was also used to evaluate the gastropexy two months after the surgery. Adhesion was confirmed two months after the surgery between the stomach wall at the pyloric antrum and the right side of the body wall in all dogs by ultrasound. The mean surgical time, length of surgical incision and score of pain were significantly lower in group E compared to group I and B (P<0.05). No significant differences were found in total gastric emptying time and gastropexy thickness post-operatively (P>0.05). Due to advantages observed in the current study, the endoscopically assisted technique seems to be a suitable alternative to open incisional and belt loop gastropexies for performing prophylactic gastropexy, especially when performed by skilled surgeons.

Effect of different types of nutrient solution on preoperative fasting time

Objective To discuss the feasibility of preoperative diet by measuring gastric emptying time of carbohydrate and protein nutrient solutions in healthy volunteers. Methods A total of 20 healthy volunteers were collected from August 2013 to May 2014. On the morning of the trial, baseline gastric residual volume of each volunteer was measured with magnetic resonance imaging at 8 a. m., then each of the 20 healthy volunteers took 12.5% carbohydrate solution 400 ml (containing 40 g of maltodextrin and 10 g of sucrose) or 12.5% whey protein solution (containing 50 g whey protein) in 5 minutes. Magnetic resonance imaging was conducted to measure the gastric residual volume every 25 minutes. The volunteers were shifted to the other nutrient solution after a 1-week interval. The gastric emptying time of both nutrient solutions was calculated to generate the curves illustrating the process of gastric emptying. Results The baseline gastric residual volume of the volunteers was (14.90±9.39) ml. The total gastric emptying time of carbohydrate solution was (104.90±27.98) min (95% CI 98.64-111.16 min), while that of whey protein solution was (199.6±34.17) min (95% CI 184.47-214.73 min). There was a significant difference between these two types of nutrient solution in terms of gastric emptying time (P<0.000 1). Conclusions The induction of anesthesia could be performed 2 hours after carbohydrate administration, and at least 4 hours after whey protein administration. Key words: Carbohydrate solution; Whey protein solution; Preoperative fasting; Gastric emptying; Magnetic resonance imaging

Dyspeptic Symptoms in Children: The Result of a Constipation-Induced Cologastric Brake?

Patients with constipation frequently complain of dyspeptic symptoms that may be explained by reflex inhibition of upper-gastrointestinal motor activity by colonic stimuli. We sought to evaluate the following: (1) the prevalence of functional constipation (FC) and gastric emptying characteristics in children with functional dyspepsia (FD), and (2) the efficacy of osmotic laxatives on constipation, dyspeptic symptoms, and gastric motility. We recruited 42 children (males/females, 22/20; mean age, 80.5 mo) affected by FD (Rome II criteria). All subjects underwent ultrasonographic measurement of the total gastric emptying time (TGEt) at baseline (T0) and after 3 months (T3). Children's bowel habits and the dyspeptic symptomatic score were evaluated at entry and after 1 (T1), 2 (T2), and 3(T3) months. Constipated patients were treated with osmotic laxatives for 3 months. Dyspeptic children without constipation represented the comparison group. FC was present in 28 of 42 (66.6%) patients. Constipated dyspeptic children had significantly more prolonged TGEt than subjects without constipation (median value [interquartile range], 180 (50) vs 150 (28) min, respectively; P = .004). Patients on osmotic laxatives had a significant decrease in TGEt at 3 months (P < .001). The median dyspeptic symptomatic score as well as the number and consistency of evacuations per week significantly improved at T1 in comparison with T0 and even more at T2 and T3 (P < .001, for each). In our study group, the majority of children with FD were affected by FC associated with delayed gastric emptying. Normalization of bowel habit may improve gastric emptying as well as dyspeptic symptoms.

Functional Gastrointestinal Disorders in Migrainous Children: Efficacy of Flunarizine

The aim of this study was to evaluate the prevalence of functional gastrointestinal disorders (FGIDs) in children with migraine headache and the effects of flunarizine on gastrointestinal manifestations. We studied 50 migrainous children (mean age 8.63 years). The clinical pattern and the diagnosis of FGIDs were obtained from structured questionnaires. All subjects underwent measurement of total gastric emptying time (TGEt) performed by real-time ultrasonography of the gastric antrum at baseline (T0). In the second part of the study, we evaluated 10 migrainous children (mean age 9.8 years) with associated FGIDs. In these 10 patients, repeated TGEt evaluation together with a detailed symptom history was obtained after 1 (T1) and 2 months (T2) of treatment with flunarizine. Control groups were composed of 10 migrainous children without FGIDs (mean age 9.2 years) and nine sex- and age-matched healthy children. Gastrointestinal disorders were present in 70% of the patients. Migrainous children with FGIDs had significantly (P < 0.01) more prolonged TGEt than subjects without FGIDs. Prior to therapy, all migrainous children with FGIDs had prolongation of TGEt compared with controls (P < 0.05). Patients on flunarizine had a significant decrease in TGEt at both 1 (P < 0.01) and 2 months (P = 0.002) of therapy. The mean frequency of abdominal pain per month was significantly (P < 0.001) reduced at T1 compared with T0. The mean frequency of vomiting per month was significantly decreased at T1 (P < 0.05) and even more so at T2 (P < 0.01). Finally, the mean frequency of headache per month was significantly reduced only at T2 (P < 0.05), whereas the mean duration of headache was significantly decreased at T1 (P < 0.01) with no difference between T1 and T2. Most children with migraine report FGIDs, associated with a delayed gastric emptying. Flunarizine decreases the frequency and duration of migrainous episodes as well as the gastrointestinal symptoms.

Residence of liquids in the infra-junctional portion of the proximal stomach in patients with gastroesophageal reflux disease

Patients with gastroesophageal reflux disease may have disturbances of gastric motility, which could play a role in the pathophysiology of the disease. Recent studies have suggested that the gastric region just below the gastroesophageal junction may have a distinct physiological behavior. We determined whether patients with gastroesophageal reflux disease have abnormal residence of food in the infra-junctional portion of the stomach after ingesting a liquid nutrient meal. Fasted adult patients with reflux disease (N = 11) and healthy volunteers (N = 10) ingested a liquid meal (320 ml; 437 kcal) labeled with 99m technetium-phytate and their total gastric emptying half-time and regional emptying from the stomach infra-junctional region were determined. In 8 patients, episodes of postprandial acidic reflux to the esophagus were measured for 2 h using pH monitoring. There were no differences between reflux patients and controls regarding total gastric emptying time (median: 68 min; range: 39-123 min vs 65 min and 60-99 min, respectively; P > 0.50). Food residence in the infra-junctional area was similar for patients and controls: 23% (range: 20-30) vs 27% (range: 19-30%; P = 0.28) and emptying from this area paralleled total gastric emptying (Rs = 0.79; P = 0.04). There was no correlation between residence of food in the infra-junctional area and episodes of gastroesophageal reflux (Rs = 0.06; P = 0.88). We conclude that it is unlikely that regional motor disturbances involving the infra-junctional region of the stomach play a relevant role in the pathogenesis of acidic gastroesophageal reflux.

Homemade gluten-free pasta is as well or better digested than gluten-containing pasta.

Homemade gluten-free pasta is as well or better digested than gluten-containing pasta.

Central regulation of gastric emptying of solid nutrient meals by corticotropin releasing factor.

Central regulation of gastric emptying of a solid nutrient meal and spatial and temporal parameters of gastro-pyloro-duodenal contractions by corticotropin-releasing factor (CRF) were investigated in conscious dogs. Intracerebroventricular (i.c.v.) infusion of CRF at 0.033 nmol kg-1 min-1 for 15 min in a volume of 0.2 mL significantly delayed the total gastric emptying time of the meal. I.c.v infusion of CRF also increased the mean frequency of proximal duodenal contractions and decreased the percentage of distally propagating contractions in the whole duodenum. The remaining parameters of pyloric and duodenal contractions were not affected. A prior i.c.v. infusion of I-helical CRF9-41 (0.166 nmol kg-1 min-1 for 15 min in a volume of 0.2 mL) blocked the central effects of CRF on gastric emptying time and the duodenal contractions. Central infusion of CRF had no significant effect on the lag phase of gastric emptying. Bilateral truncal vagotomy significantly delayed the gastric emptying time of the solid nutrient meal. However, after vagotomy, i.c.v. infusion of CRF had no effect on gastric emptying time or the spatial and temporal parameters of gastro-pyloro-duodenal contractions. In conclusion, CRF, the mediator of stress response, delays the total gastric emptying time of solid nutrient meals. The delay in gastric emptying may not be due to a change in the spatial and temporal parameters of gastric or pyloric contractions, but mainly due to changes in the parameters of duodenal contractions. The central effects of CRF on gastric emptying and duodenal contractions may be mediated by the vagus nerves.

The amount of food ingested in a single meal by rainbow trout offered chopped herring, dry and wet diets

Two-year-old 1&middot;5-kg rainbow trout were held in cages and conditioned by feeding either on low-fat chopped herring (H trout) or dry pellets (P trout) for 15 weeks. Their satiation amounts were then determined under standard conditions. On a wet weight basis H trout ate 2&middot;5-3&middot;5 times more food than P trout; this was sufficient to compensate for the high water content of herring and thereby maintain the dry matter intake. When P trout were offered herring (PH trout) they consumed more food than when offered dry pellets but not as much as H trout. Stomach capacity restricted the intake and their dry matter intake was reduced by c. 40%. When H trout were offered dry pellets (HP trout) they adjusted their intake immediately close to the level of P trout although their larger stomachs could have accommodated more than twice this volume of dry food. The return of appetite after a satiation meal was almost linear with time. Appetite increased at c. 556 mg g-1 body weight h-1 for H trout and at 142 mg g-1 bw h-1 for P trout. The return of appetite in PH trout was significantly slower (c. 370 mg g-1 bw h-1) than in H trout; the previous dietary history of the PH trout limited their capacity to process larger volumes of wet food in a single meal. Fish offered dry diet (P and HP trout) had similar rates of appetite return despite their previous feeding history suggesting that the property of the dry feed itself might limit meal size. The total gastric emptying time of diets of similar dry matter content (with and without large amounts of water) was similar, but the delay time before gastric emptying starts tended to be longer for dry diets. Dry pellets appear to impose a demand for water that prolongs the gastric delay. This water demand is met partly by drinking since the trout fed on dry pellets drank significantly more (436&plusmn;189 mg kg-1 h-1) than unfed and herring-fed trout which drank little or not at all (65&plusmn;113 and 70&plusmn;66 mg kg-1 h-1 respectively). Dietary water facilitated food processing and increased daily dry matter intake of trout when fed four times a day. When only one satiation meal per day was allowed, dietary water had no effect. It is concluded from this work that, in addition to gastric volume, a short-term limitation on the size of satiation meals in the rainbow trout is the availability of water to moisturize the food and thus to promote gastric digestion and emptying. 1997 The Fisheries Society of the British Isles

Gastric emptying of a solid meal is accelerated by the removal of dietary fibre naturally present in food.

Exogenous fibre added to liquid meals delays gastric emptying. Its effect on solid meals is uncertain, and nothing is known of the effect on gastric emptying of fibre naturally present in food. This study therefore looked at gastric emptying of two different solid meals in eight healthy subjects and their blood glucose responses. The meals were exactly equivalent except for the total dietary fibre content (high fibre 20 g, low fibre 4 g of dietary fibre per 1000 kcal) and supplied 870 kcal (700 kcal women), 47% of which was from carbohydrates, 36% from fats, and 17% from proteins. Ultrasonography was used to measure antral diameters before the meal (basal), immediately after it (time 0), and at 30, 60, 120, 180, 240, and 300 minutes. In addition, subjects filled in a questionnaire on their feelings of hunger, epigastric fullness, and satiety before the meal and at hourly intervals after it. Basal and maximal postprandial antral sections were similar for the two meals (basal section: 283.9 (29.5) v 340.9 (44.7) mm2 for the low and the high fibre meal, NS; maximal postprandial section: 1726 (101.9) v 1593 (120.4) mm2, NS). Total gastric emptying time was significantly reduced by fibre removal (186.0 (15.6) v 231.7 (17.3) minutes after the low and the high fibre meal, p < 0.05). Blood glucose was higher after the low fibre meal, and the area under the glycaemic curve significantly greater (226 (23.1) v 160 (20.0) mmol/min/dl-1, p < 0.05). No difference was found in satiety or fullness feelings, but hunger returned more rapidly after the low fibre meal. In conclusion, fibre naturally present in food delays gastric emptying of a solid meal, reduces the glycaemic response, and delays the return of hunger.

THE USE OF A BARIUM MEAL TO EVALUATE TOTAL GASTRIC EMPTYING TIME IN THE DOG

Total gastric emptying time was determined in nine mongrel dogs using a barium meal contrast procedure. Within the group, total gastric emptying time ranged from 7.0–15.0 hours. Comparison of the population mean showed a statistical difference (p − 0.01) from previously published values. Individual dogs showed consistent total gastric emptying time over three trials. The technique can be used to test the effect of a procedure on total gastric emptying time when a normal value has been established for the dog. Due to the wide range of normal values observed, evaluation of clinical patients could be difficult unless there is a gross abnormality in function.

Measurement of gastric emptying time by real-time ultrasonography

This paper describes an ultrasound method of assessing gastric emptying time based on measurements of the gastric antrum, which is visible in almost all subjects before and after meals. A total of 54 subjects were examined including 18 normal subjects and 36 subjects with idiopathic functional dyspepsia. The emptying time was determined in all subjects by measuring the changes in the crosssectional area of the gastric antrum. In a subgroup of 34 subjects the volume of the whole antropyloric region was also considered. Measurements were taken by the same observer after fasting and at regular 30-min intervals after a standard 800-cal meal. Final emptying time (calculated in relation to the start of the meal) was considered to be the time at which the antral area or volume returned to basal value. Final emptying time (mean ± SD) was 248 ± 39 min in normal subjects and 359 ± 64 min in patients with functional dyspepsia (p < 0.001). A significantly higher degree of dilatation of the gastric antrum was found in dyspeptic patients than in control subjects. Barium x-ray of the stomach in 19 subjects always confirmed the ultrasound finding on the presence or absence of contents within the stomach. We conclude that this kind of ultrasound study of the antropyloric region allows accurate determination of total gastric emptying time.

Patterns of canine gastric electrical activity.

Patterns of canine gastric electrical activity.