Jesus Rafael Diaz MD, Presenter: Nothing to Disclose

Arya Bagherpour DO, Abstract Co-Author: Nothing to Disclose

Joshua Reber, Abstract Co-Author: Nothing to Disclose

Alok Kumar Dwivedi PhD, Abstract Co-Author: Nothing to Disclose

Luis Andres Alvarado MS, Abstract Co-Author: Nothing to Disclose

Irene Sarosiek MD, Abstract Co-Author: Nothing to Disclose

Richard W. McCallum MD, Abstract Co-Author: Nothing to Disclose

Rapid gastric emptying (RGE) has been associated with gastric surgery and vagotomy in the past but surgery for peptic ulcer disease is now infrequent. The purposes of our study are: 1( To determine the incidence of RGE in patients with symptoms suggesting an upper GI motily disorder referred to a Tertiary GI Motility Center; 2) To identify the dominant etiologies currently responsible for RGE, and 3) To highlight the diagnostic power of the 30-min retention value on scintigraphy.

We reviewed the results of 223 gastric emptying scintigraphy (GES) studies from January to December 2013 . Age, gender and ethnicity were documented. All patients underwent 4-h GEST with a standardized egg beater meal (255-kCal, 2% fat) labeled with Tc-99m sulfur colloid. RGE was defined as <70% retention at 30 min or <35% retention at 60 min. Delayed gastric empting was defined as >60% retention at 2 h or >10% retention at 4 h. Statistical analysis using McNemar’s test was performed to calculate the diagnostic power of the 30-min compared to the 60-min retention value.

Of the 223 patients, 25.5% were classified as normal, 35% as delayed and 39.5% as rapid. Of these 88 patients with RGE, 76% were female with median age of 58, 46.5% were diabetic, 31% were termed idiopathic with a history of preceding gastroenteritis in many, 12.5% had cyclic vomiting syndrome (CVS) and 10% were postsurgical. The 30-min retention value diagnosed 26% more patients with RGE than the 60-min retention value; a significant additional percentage (P <0.05). RGE incidence was similar in Hispanics and Non-Hispanics.

Analysis of GES performed in 2013 demonstrated: 1) There is an increasing incidence of RGE detected in patients referred with symptoms suggesting an upper GI motility disorder -39.5%- greater than reported in the literature (10-13%), and comparable to the incidence of gastroparesis; 2) The 30-min value diagnosed significantly more patients compared to the 60-min value and 3) While diabetes continues to be the dominant etiology for RGE, there are increasing contributions from idiopathic and CVS subgroups.

Our data would indicate that there should be a heightened awareness of the increased incidence of RGE in patients referred with suspected upper GI motility disorders where gastroparesis has been the presumptive diagnosis. Clinical differentiation between the two entities can be essentially indistinguishable.

Diaz, J, Bagherpour, A, Reber, J, Dwivedi, A, Alvarado, L, Sarosiek, I, McCallum, R, The Increasing Recognition of Rapid Gastric Emptying by Scintigraphy in Patients Referred to a Tertiary Center for Suspected Upper Gastrointestinal Motility Disorder..  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016427.html