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Gastric Emptying
Paula Vergara-Wentland, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Normal gastric physiology
              • Normal capacity of stomach varies 0.25-1.7 L
              • Solid emptying mostly due to peristaltic pump 
                • Active contractile waves and pyloric opening
                • Solid curve analysis
                  • Phase 1 (lag phase): Retained in gastric fundus, transported to antrum where diluted, ground (~ 60 min post ingestion)
                  • Phase 2: Antropyloric wave-like contractions dilute, empty into duodenum
              • Liquid emptying mostly due to pressure pump   
                • Global tonic stomach contractions and pyloric opening
                • Liquid curve analysis
                  • Empties directly into duodenum, no lag phase
                  • Depends on differential pressures between stomach and small bowel and pyloric opening (pressure pump)

          IMAGING

          • General Features

            • Imaging Recommendations

              DIFFERENTIAL DIAGNOSIS

                PATHOLOGY

                • General Features

                  CLINICAL ISSUES

                  • Presentation

                    • Treatment

                      DIAGNOSTIC CHECKLIST

                      • Consider

                        Selected References

                        1. Cooper CJ et al: Rapid or normal gastric emptying as new supportive criteria for diagnosing cyclic vomiting syndrome in adults. Med Sci Monit. 20:1491-5, 2014
                        2. Shin AS et al: Diagnostic assessment of diabetic gastroparesis. Diabetes. 62(8):2667-73, 2013
                        3. Sachdeva P et al: Gastric emptying of solids and liquids for evaluation for gastroparesis. Dig Dis Sci. 56(4):1138-46, 2011
                        4. Ziessman HA et al: The added diagnostic value of liquid gastric emptying compared with solid emptying alone. J Nucl Med. 50(5):726-31, 2009
                        5. Couturier O et al: Gastric scintigraphy with a liquid-solid radiolabelled meal: performances of solid and liquid parameters. Nucl Med Commun. 25(11):1143-50, 2004
                        6. Heyman S: Gastric emptying in children. J Nucl Med. 39(5):865-9, 1998
                        7. SMMI Procedure Guideline for Adult Solid-Meal Gastric-Emptying Study 2009
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Clinical Issues

                              • Diagnostic Checklist

                                TERMINOLOGY

                                • Definitions

                                  • Normal gastric physiology
                                    • Normal capacity of stomach varies 0.25-1.7 L
                                    • Solid emptying mostly due to peristaltic pump 
                                      • Active contractile waves and pyloric opening
                                      • Solid curve analysis
                                        • Phase 1 (lag phase): Retained in gastric fundus, transported to antrum where diluted, ground (~ 60 min post ingestion)
                                        • Phase 2: Antropyloric wave-like contractions dilute, empty into duodenum
                                    • Liquid emptying mostly due to pressure pump   
                                      • Global tonic stomach contractions and pyloric opening
                                      • Liquid curve analysis
                                        • Empties directly into duodenum, no lag phase
                                        • Depends on differential pressures between stomach and small bowel and pyloric opening (pressure pump)

                                IMAGING

                                • General Features

                                  • Imaging Recommendations

                                    DIFFERENTIAL DIAGNOSIS

                                      PATHOLOGY

                                      • General Features

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Cooper CJ et al: Rapid or normal gastric emptying as new supportive criteria for diagnosing cyclic vomiting syndrome in adults. Med Sci Monit. 20:1491-5, 2014
                                              2. Shin AS et al: Diagnostic assessment of diabetic gastroparesis. Diabetes. 62(8):2667-73, 2013
                                              3. Sachdeva P et al: Gastric emptying of solids and liquids for evaluation for gastroparesis. Dig Dis Sci. 56(4):1138-46, 2011
                                              4. Ziessman HA et al: The added diagnostic value of liquid gastric emptying compared with solid emptying alone. J Nucl Med. 50(5):726-31, 2009
                                              5. Couturier O et al: Gastric scintigraphy with a liquid-solid radiolabelled meal: performances of solid and liquid parameters. Nucl Med Commun. 25(11):1143-50, 2004
                                              6. Heyman S: Gastric emptying in children. J Nucl Med. 39(5):865-9, 1998
                                              7. SMMI Procedure Guideline for Adult Solid-Meal Gastric-Emptying Study 2009