Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients' characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value < 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies. Copyright © 2015 Via Medica

Noninvasive ¹³C-octanoic acid breath test shows delayed gastric emptying in patients with amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive loss of motor neurons. However, ALS has been recognized to also involve non-motor systems. Subclinical involvement of the autonomic system in ALS has been described. The recently developed C-13-octanoic acid breath test allows the noninvasive measurement of gastric emptying. With this new technique we investigated 18 patients with ALS and 14 healthy volunteers. None of the patients had diabetes mellitus or other disorders known to cause autonomic dysfunction. The participants received a solid standard test meal labeled with C-13-octanoic acid. Breath samples were taken at 15-min intervals for 5 h and were analyzed for (CO2)-C-13 by isotope selective nondispersive infrared spectrometry. Gastric emptying peak time (t(peak)) and emptying half time (t(1/2)) were determined. All healthy volunteers displayed normal gastric emptying with a mean emptying t(1/2) of 138 +/- 34 (range 68-172) min. Gastric emptying was delayed (t(1/2) > 160 min) in 15 of 18 patients with ALS. Emptying t(1/2) in ALS patients was 218 +/- 48 (range 126-278) min (p < 0.001). These results are compatible with autonomic involvement in patients with ALS, causing delayed gastric emptying of solids and encouraging the theory that ALS is a multisystem disease rather than a disease of the motor neurons only

Quantitative detection of atropine-delayed gastric emptying in the horse by the ¹³C-octanoic acid breath test

The &lt;sup&gt;13&lt;/sup&gt;C-octanoic acid breath test has been correlated significantly to radioscintigraphy for measurement of gastric emptying indices in healthy horses. The objective of this study was to investigate the validity of the test for measurement of equine delayed gastric emptying, prior to its potential clinical application for this purpose. A model of atropine- induced gastroparesis was used. Gastric emptying rate was measured twice in 8 horses using concurrent radioscintigraphy and/or breath test after treatment i.v. with either atropine (0.035 mg/kg bwt) or saline in randomised order. Analysis of both data sets demonstrated that the atropine treatment had caused a significant delay in gastric emptying rate. Paired breath test data showed an atropine-induced delay in gastric half-emptying time t(1/2)), with no overlap in the 99% Cl range (P&#60;0.001). Significant correlations were found between scintigraphy and &lt;sup&gt;13&lt;/sup&gt;C-octanoic acid breath test for calculation of both t(1/2) (P&#60;0.01) and lag phase duration (P&#60;0.05) in the atropine-delayed emptying results. The mean (s.d.) bias in breath test t(1/2) when compared with scintigraphy was 1.78 (0.58) h. The results demonstrated that the &lt;sup&gt;13&lt;/sup&gt;C-octanoic acid breath test was an effective diagnostic modality for the measurement of equine delayed gastric emptying. The technique offers advantages to existing methods for clinical investigation, as it is noninvasive, not radioactive, quantitative and requires minimal equipment or training to perform

Intraoperative fluid restriction in pancreatic surgery : a double blinded randomised controlled trial

Background : Perioperative fluid restriction in a variety of operations has shown improvement of: complications, recovery of gastrointestinal function and length of stay (LOS). We investigated effects of crystalloid fluid restriction in pancreatic surgery. Our hypothesis: enhanced recovery of gastrointestinal function. Methods : In this double-blinded randomized trial, patients scheduled to undergo pancreatoduodenectomy (PD) were randomized: standard (S: 10ml/kg/hr) or restricted (R:5ml/kg/hr) fluid protocols. Primary endpoint: gastric emptying scintigraphically assessed on postoperative day 7. Results : In 66 randomized patients, complications and 6-year survival were analyzed. 54 patients were analyzed in intention to treat: 24 S-group and 30 R-group. 32 patients actually underwent a PD and 16 patients had a palliative gastrojejunostomy bypass operation in the full protocol analysis. The median gastric emptying time (T1/2) was 104 minutes (S-group, 95% confidence interval: 74-369) versus 159 minutes (R-group, 95% confidence interval: 61-204) (P = 0.893, NS). Delayed gastric emptying occurred in 10 patients in the S-group and in 13 patients in the R-group (45% and 50%, P = 0.779, NS). The primary outcome parameter, gastric emptying time, did not show a statistically significant difference between groups. Conclusion : A fluid regimen of 10ml/kg/hr or 5ml/kg/hr during pancreatic surgery did not lead to statistically significant differences in gastric emptying. A larger study would be needed to draw definite conclusions about fluid restriction in pancreatic surgery

Gastric emptying and plasma glucose response in men following ingestion of milk from different species : thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutritional Science at Massey University, Palmerston North, New Zealand

The 13 C Octanoic acid breath test (OABT) was used to measure the rate of gastric emptying of whole goat's milk (WG), whole cow's milk (WC), goat's milk infant formula (GIF) and cow's milk infant formula (CIF) in healthy, adult men. Prior to the gastric emptying study, the integrity of the vacuum in two commonly used gas collection tubes was tested. The experiment showed that the Exetainer® brand of tube was more suitable for collecting expired air compared to the Vacutainer® brand based on the fact that it had less residual dead-space which could dilute expired air samples. Fifteen healthy men were given one of the four test milks containing 100μg 13 C octanoic acid after an overnight fast. Breath samples were collected at regular intervals for four hours. Following analysis by ratio isotope mass spectrometry, gastric emptying parameters were calculated. The gastric emptying half time (t 1/2 ) of CIF was significantly shorter (P<0.05) than that of GIF (120 min vs. 159 min), but there were no differences in the rate of emptying between WC (141 min) and WG (150 min). There were no significant differences between either of the infant formulas and the whole milks. Blood samples were taken concurrently with the expired air samples. The samples were analysed to determine plasma glucose concentration. The results of showed that the timing of the peaks of plasma glucose levels and subsequent drop to below baseline concentration may be associated with the rate of gastric emptying. The manner in which the four test milks coagulated was also tested. Milks were incubated in vitro at 37.5°C after acidification with l molar HCl (to gastric pH 3) and addition of the enzyme pepsin. Vastly different coagulation properties were observed. The WC formed large curds with a clear separation between the whey-containing liquid and the curd whereas the WG and GIF were more homogenous with finer curds and considerably less clear fluid. The CIF exhibited very fine curds. Differences in composition between whole goat's milk and whole cow's milk did not appear to be sufficient to elicit different rates of gastric emptying. Thus any nutritional differences between milk from the two species may not be related to the rate at which they are emptied from the stomach

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients’ characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value < 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studie

The Traditional Japanese Medicine Rikkunshito Promotes Gastric Emptying via the Antagonistic Action of the 5-HT3 Receptor Pathway in Rats

The traditional Japanese medicine rikkunshito ameliorates the nitric oxide-associated delay in gastric emptying. Whether rikkunshito affects gastric motility associated with 5-hydroxytryptamine (serotonin: 5-HT) receptors or dopamine receptors is unknown. We examined the effects of rikkunshito on the delay in gastric emptying induced by 5-HT or dopamine using the phenol red method in male Wistar rats. 5-HT (0.01–1.0 mg kg−1, i.p.) dose dependently delayed gastric emptying, similar to the effect of the 5-HT3 receptor agonist 1-(3-chlorophenyl) biguanide (0.01–1.0 mg kg−1, i.p.). Dopamine also dose dependently delayed gastric emptying. The 5-HT3 receptor antagonist ondansetron (0.04–4.0 mg kg−1) and rikkunshito (125–500 mg kg−1) significantly suppressed the delay in gastric emptying caused by 5-HT or 1-(3-chlorophenyl) biguanide. Hesperidin (the most active ingredient in rikkunshito) suppressed the 5-HT-induced delayed gastric emptying in a dose-dependent manner, the maximum effect of which was similar to that of ondansetron (0.4 mg kg−1). The improvement obtained by rikkunshito or ondansetron in delaying gastric emptying was completely blocked by pretreatment with atropine. Rikkunshito appears to improve delay in gastric emptying via the antagonistic action of the 5-HT3 receptor pathway

Effects of l-tryptophan on gastric emptying evaluated by breath test in relation to gastric accommodation evaluated by Barostat in rats

AbstractGastric emptying has been known to correlate the pyloric sphincter contractile function and distention-induced gastric relaxation (gastric accommodation). In the present study, the effects of l-tryptophan on the gastric emptying and accommodation were evaluated by breath test using [1-13C]acetic acid and Barostat study, respectively, in rats. l-Tryptophan significantly decreased Cmax and AUC120min and delayed Tmax, indicating the inhibition of gastric emptying. l-Tryptophan significantly enhanced the gastric accommodation. These findings show that l-tryptophan may inhibit the gastric emptying through the enhanced gastric accommodation. Therefore, l-tryptophan may be useful for the therapy of postprandial dyspepsia, especially for early satiety

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients’ characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value &lt; 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies