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- What is a gastric emptying study?
- How is a gastric emptying study done?
- When is a gastric emptying study used?
- How are the results of a gastric emptying study evaluated?
- Are there any side effects of a gastric emptying study?
- Are there other tests that can be performed instead of a gastric emptying study?
What is a gastric emptying study?
The most common type of gastric emptying study is a procedure that is done by nuclear medicine physicians using radioactive chemicals that measures the speed with which food empties from the stomach and enters the small intestine. Gastric emptying studies are used for evaluating patients who are having symptoms that may be due to slow and, less commonly, rapid emptying of the stomach. The symptoms of slow emptying are primarily nausea, vomiting, abdominal pain, and abdominal fullness after eating. The symptoms of rapid emptying are diarrhea, weakness, or light-headedness after eating.
How is a gastric emptying study done?
For a gastric emptying study, a patient eats a meal in which the solid component of the meal (for example, scrambled eggs or oatmeal for vegetarians), the liquid component of the meal (for example, water), or both, are mixed with a small amount of radioactive material. A scanner (acting like a Geiger counter) is placed over the patient's stomach to monitor the amount of radioactivity in the stomach for several hours after the test meal is eaten. As the radioactively-labeled food empties from the stomach, the amount of radioactivity in the stomach decreases. The rate at which the radioactivity leaves the stomach reflects the rate at which food is emptying from the stomach
Some medications such as narcotic pain relievers and anticholinergic medications can cause a delay in emptying of the stomach, while other medications such as metoclopramide (Reglan) and erythromycin can cause rapid emptying of the stomach. Medications that slow emptying of the stomach can give a falsely abnormal test result, while medications that speed up emptying of the stomach can give a falsely normal result. Therefore, medications that affect emptying of the stomach should be withheld for 72 hours before performing emptying studies.
Abnormally high blood glucose (sugar) levels also can slow emptying of the stomach. Therefore, it is important to control blood glucose levels to near normal levels before performing emptying studies in people with diabetes who are prone to develop high blood glucose levels.
Quick GuideHeartburn: Foods to Eat, Foods to Avoid
When is a gastric emptying study used?
A gastric emptying study often is used when there is a suspicion that there is an abnormally delayed emptying of food from the stomach, medically called delayed gastric emptying. Delayed gastric emptying most commonly gives rise to abdominal discomfort after meals, nausea and vomiting. The two most common causes of delayed gastric emptying are gastric outlet obstruction and gastroparesis.
Gastric outlet obstruction refers to a condition in which the narrow channel leading from the stomach into the small intestine through which food passes (called the pylorus) is physically blocked, and, as a result food enters the first part of the small intestine (called the duodenum) slowly or not at all. The most common causes of gastric outlet obstruction are scarring or inflammation of the pylorus from peptic ulcers, cancers of the stomach, or, occasionally, cancers near the pylorus, for example, of the pancreas or duodenum. A diagnosis of gastric outlet obstruction is made by tests such as esophagogastroduodenoscopy (EGD), abdominal computerized tomography (CT scan), and upper GI series.
Once gastric outlet obstruction has been excluded by appropriate testing as the cause of delayed gastric emptying, physicians then may perform a gastric emptying study to diagnose gastroparesis. Gastroparesis is a condition in which there is delayed gastric emptying, but the delay is not due to obstruction. Rather, it is due to abnormal function of the muscles of the stomach. Normal function of the stomach's muscles is necessary in order to propel food from the stomach and into the small intestine. If the muscles or the nerves that control the muscles are not working normally, food remains in the stomach. Gastroparesis is commonly caused by diseases and medications. The most common cause of gastroparesis is diabetes mellitus, which affects the function of the stomach's nerves and muscles. Many cases of gastroparesis have no clear cause for the dysfunction. These cases are referred to as idiopathic gastroparesis.
A gastric emptying study also may be used when there is a suspicion that there is abnormally rapid gastric emptying. Rapid gastric emptying can cause diarrhea and episodes of weakness or light-headedness following meals (referred to as the "dumping" syndrome). Common causes of rapid gastric emptying include surgery of the stomach and diabetes mellitus.
How are the results of a gastric emptying study evaluated?
In patients with gastroparesis, the food and the attached radioactive material remain in the stomach longer than normal (usually hours) before emptying into the small intestine. As a result, the scanner continues to show radioactivity in the area of the stomach for hours after the test meal. If abnormally slow emptying is demonstrated, medications such as metoclopramide (Reglan) may be given to speed up the emptying and improve symptoms. If abnormally rapid emptying of the stomach is found, medications may be given to slow down emptying.
Are there any side effects of a gastric emptying study?
There are no side effects from a gastric emptying study. The radioactive material is not absorbed into the body and is eliminated in the stool. Nevertheless, gastric emptying studies as well as any other studies that utilize radioactive materials should not be performed in pregnant women because the fetus is exposed to some radioactivity.
Are there other tests that can be performed instead of a gastric emptying study?
An upper gastrointestinal (GI) series X-ray demonstrates abnormal emptying of barium in patients with severe a emptying problem, however, it cannot diagnose abnormal emptying of a mild or moderate degree. An antro-duodenal motility study or an electrogastrogram can demonstrate abnormalities in the muscles and nerves of the stomach, but they do not directly evaluate the effects of these abnormalities on emptying of the stomach. Other experimental methods for evaluating emptying of the stomach have been described, for example, ultrasonography, breath tests using fatty acids, and single photon emission computerized tomography (SPECT) but these tests are available in very few centers.
"Gastroparesis: Etiology, clinical manifestations, and diagnosis"
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Abdominal Pain (Causes, Remedies, Treatment)
Abdominal pain can have many causes that range from mild to severe. Some of these causes include bloating, gas, colitis, endometriosis, food poisoning, GERD, IBS (irritable bowel syndrome), ovarian cysts, abdominal adhesions, diverticulitis, Crohn's disease, ulcerative colitis, gallbladder disease, liver disease, and cancers.
Signs and symptoms of the more serious causes include dehydration, bloody or black tarry stools, severe abdominal pain, pain with no urination or painful urination.
Treatment for abdominal pain depends upon the cause.
Antro-duodenal Motility StudyAn antro-duodenal motility study is used to diagnose motility disorders of the stomach or small intestine. Symptoms of a motility disorder include nausea, vomiting, and intestinal distention. One common cause of a stomach or intestinal motility disorder is diabetes mellitus.
CAT ScanA CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal fluid to enhance the scan.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some diseases and conditions that do not involve the GI tract. Indigestion can be a chronic condition in which the symptoms fluctuate infrequency and intensity. Signs and symptoms that accompany indigestion include pain in the chest, upper abdominal pain, belching, nausea, bloating, abdominal distention, feeling full after eating only a small portion of food, and rarely, vomiting.
During pregnancy indigestion may become worse. Home remedies, medication, and lifestyle changes can help relieve and cure indigestion its symptoms.
ElectrogastrogramAn electrogastrogram is a test that measures the electrical signals that measure how the muscles of the stomach contract.
Endoscopic UltrasoundEndoscopic ultrasound (EUS) uses ultrasound and endoscopy to take pictures of the digestive tract and the surrounding tissues and organs. EUS may be useful in making several medical determinations, including:
- staging of cancers of the esophagus, stomach, pancreas and rectum,
- staging of lung cancer,
- evaluating chronic pancreatitis,
- studying gallstones and tumors in the bile duct, gallbladder, and liver,
- evaluating reasons for fecal incontinence,
- and studying submucosal lesions.
- drug reactions,
- and a lump in the skin where the IV was placed.
GastroparesisGastroparesis is a medical condition in which the muscle of the stomach is paralyzed by a disease of either the stomach muscle itself or the nerves controlling the muscle. As a consequence, food and secretions do not empty normally from the stomach. Gastroparesis symptoms are nausea and vomiting; abdominal bloating, and pain can result.
Take the GERD QuizWho is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about it.
Intestinal Gas (Belching, Bloating, Flatulence)
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air.
Causes of bloating or distension include tumors, ascites, fluid within the gastrointestinal (GI) tract, and obesity.
Causes of gas or flatulence are diseases such as sugary foods and drinks, fruits and vegetables, starches (wheat, oats, corn, and potatoes), lactose intolerance, untreated celiac disease, and SIBO.
Treatment for excessive intestinal gas depends on the cause. If anal itching persists, a doctor examination may be needed to identify an underlying cause.
Intestines PictureThe intestines are a long, continuous tube running from the stomach to the anus. See a picture of the Intestines and learn more about the health topic.
Upper GI SeriesAn upper gastrointestinal GI series, or barium swallow is a test used in assisting in the diagnosis of upper gastrointestinal diseases or conditions such as:
- hiatal hernias,
- blockages, and
- abnormalities of the muscular wall of the GI tract.