[13C]octanoic acid breath test for gastric emptying of solids: Accuracy, reproducibility, and comparison with scintigraphy

Choi, MG; Camilleri, Michael; Burton, DD; Zinsmeister, A. R.; Förström, L; Nair, Kavita

doi:10.1016/s0016-5085(97)70126-4

Cited by 186 publications

(192 citation statements)

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“…Few reports have clearly shown which of Tmax and T1/2b is more reliable as an emptying parameter. In contrast to the results of Ghoos et al (1993), Choi et al (1997) and demonstrated a much weaker correlation between T1/2b and T1/2s. Nakada et al (2002) and Shirasaka et al (2002) seem to hold the view that T1/2b has no advantage over Tmax in the gastric emptying breath test.…”

Section: Introductioncontrasting

confidence: 99%

“…The first one is that Tmax and T1/2b were not compared against scintigraphically measured parameters, such as T1/2s. Regardless of the widespread use of the [ 13 C]-octanoate breath test, the discrepancy between the scintigraphic and the breath test measurements has been challenged (Choi et al, 1997). The Wagner-Nelson method can diminish the discrepancy by adjusting the time for [ 13 CO2] to be retained in the bicarbonate pools (Sanaka et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

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Reliability of the time to maximal [13CO2] excretion and the half-[13CO 2] excretion time as a gastric emptying parameter: Assessments using the Wagner-Nelson method

Sanaka

Yamamoto

Nakayama

et al. 2007

J. Smooth Muscle Res.

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In the [ 13 C]-octanoate breath test, two popular parameters have been used to quantify gastric emptying rates, namely the time to the maximal [ 13 CO2] excretion (Tmax) and the time to the half-[ 13 CO2] recovery (T1/2b). Although each of Tmax and T1/2b is closely correlated with the scintigraphic half-emptying time, the two parameters occasionally indicate different judgments on a gastric emptying rate. In this study, to clarify which of the two parameters is more reliable, Tmax and T1/2b were compared to the "reference" parameters calculated using the Wagner-Nelson method, which allows accurate estimation of a time-course of gastric emptying from breath data. Ten healthy male volunteers underwent the breath test after ingestion of a muffin meal (320 kcal) containing 100 mg [ 13 C]-octanoate. Breath samples were collected at 15-min intervals for 6 h. According to the conventional analytical algorithm, Tmax and T1/2b were mathematically calculated. By applying Wagner-Nelson analysis to the breath test, the time-percent gastric retention curve was generated and the half-emptying time (T1/2WN) was determined. T1/2WN was more closely correlated with Tmax (r=0.954, P<0.0001) than with T1/2b (r=0.782, P=0.008). Tmax was significantly correlated with the percent gastric retention value in the early (t=0.25 and 0.5 h), the middle (t=1.0 and 1.5 h), and the late (t=2.0 h) postprandial phase. T1/2b was significantly correlated with the gastric retention value in the middle and the late phase, but not with the gastric retention value in the early phase. The present results show that T1/2b has limited capability to reflect gastric emptying in the early postprandial period, suggesting that Tmax is more reliable than T1/2b as a gastric emptying parameter.

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Section: Introductioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reliability of the time to maximal [13CO2] excretion and the half-[13CO 2] excretion time as a gastric emptying parameter: Assessments using the Wagner-Nelson method

Sanaka

Yamamoto

Nakayama

et al. 2007

J. Smooth Muscle Res.

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“…There is significant intraindividual variation in gastric emptying rates of 12-15%, even in healthy individuals (25,34). The relationship of gastric emptying rates of the 200-kcal meal to symptoms remains controversial (122).…”

Section: Gastric Emptying Scintigraphymentioning

confidence: 99%

“…In studies comparing 13 C gastric emptying breath tests (GEBT) performed simultaneously with scintigraphy, the 13 C GEBT provides an accurate assessment of the gastric emptying of solids with an acceptable coefficient of variation that is comparable to scintigraphy (25) and is similar with two different meal substrates [egg and biscuit (77)]. 13 C-S. platensis GEBT was able to identify accelerated or delayed gastric emptying induced pharmacologically with erythromycin or atropine (134).…”

Section: Stable Isotope Breath Testsmentioning

confidence: 99%

Methods for measurement of gastric motility

Szarka¹,

Camilleri²

2009

American Journal of Physiology-Gastrointestinal and Liver Physi

104

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Szarka LA, Camilleri M. Methods for measurement of gastric motility. Am J Physiol Gastrointest Liver Physiol 296: G461-G475, 2009. First published January 15, 2009 doi:10.1152/ajpgi.90467.2008There is an array of tests available to measure gastric motility. Some tests measure end points, such as gastric emptying, that result from several different functions, whereas other tests are more specific and test only a single parameter, such as contractility. This article reviews the tests most commonly available in practice and research to evaluate in vivo the gastric functions of emptying, accommodation, contractility, and myoelectrical activity. The rationale for testing, the relative strengths and weaknesses of each test, and technical details are summarized. We also briefly indicate the applications and validations of the tests for use in experimental animal studies. contractility; emptying; accommodation; gastroparesis; dyspepsia ASSESSMENT OF THE MOTOR FUNCTIONS (motility) of the stomach is important in studies of gastric physiology and pathophysiology. Although not generally applied in gastroenterological practice, there is increasing use of tests to evaluate gastric function, particularly less invasive tests in clinical settings.There is an array of tests available to measure gastric motility. Some tests measure end points, such as gastric emptying, that result from several different functions, whereas other tests are more specific and test only a single parameter, such as contractility. This article reviews the tests most commonly available in practice and research to evaluate in vivo the gastric functions of emptying, accommodation, contractility, and myoelectrical activity. The rationale for testing, the relative strengths and weaknesses of each test, and technical details are summarized. A brief discussion is also provided for methods that have been used in animals to study motor functions of the stomach in animals. Tests to Evaluate Gastric Emptying of SolidsGastric emptying is a composite end point reflecting a variety of functions including gastric accommodation, the pressure gradient between the proximal and distal stomach, and antropyloroduodenal contractility and coordination. The trituration of solids and emptying of solid and liquid food from the stomach are arguably the most important physiological functions of the stomach. Abnormal gastric emptying, either accelerated at 1 h or delayed at 4 h, is among the factors that contribute to reporting of dyspepsia or the development of postprandial symptoms after meal challenge (35). For all tests of gastric motility and emptying, there are standard precautions (1): 1) Drugs affecting gastric motility (e.g., anticholinergics, narcotics, and prokinetics) are stopped for 48 h prior to the test, and the study is performed in the morning after an overnight fast. 2) Diabetic subjects should have a glucose level Ͻ275 mg/dl. 3) At the time the meal is ingested, Type 1 diabetic patients should receive half of their normal insulin dose. Gastric Emptying Scintigrap...

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“…This emphasises the need for less complicated methods of evaluating GE in this subset of patients. In this context, different breath tests 19 have been tried but their possible inaccuracy and the need for cumbersome calculations may cause problems and more reliable and simplified tests are under development. 20 It is unlikely that patient drop-out influenced the outcome significantly, since there were no differences in baseline clinical characteristics between those included or excluded.…”

Section: Methodological Considerations (Patients)mentioning

confidence: 99%

Gastric emptying after autologous haemopoietic stem-cell transplantation: a prospective trial

Johansson

Abrahamsson

Ekman

2003

Bone Marrow Transplant

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Summary:Gastroparesis may be involved in the pathophysiology of prolonged nausea and vomiting after haemopoietic stemcell transplantation (HSCT), but this has not been prospectively investigated. Gastric emptying (GE) was investigated in 20 patients before and 2 months after autologous HSCT. Gastrointestinal symptoms were graded prospectively and oral energy intake was recorded in parallel. Before transplant, all patients were asymptomatic and GE was within the reference range. Post transplant GE was delayed in three patients and three patients reported nausea and/or vomiting. Neither gastrointestinal symptoms nor oral energy intake post transplant discriminated between patients with or without delayed GE. Oral energy intake before transplant was lower (P ¼ 0.05), and there was a greater need for total parenteral nutrition (TPN) among patients who developed gastroparesis post transplant (Po0.05). Delayed GE after HSCT was found to be less common than had been believed from retrospective studies. Gastroparesis may be involved in some cases of prolonged nausea and vomiting after autologous HSCT but alternative explanations should be considered. Symptoms consistent with gastroparesis did not correlate with GE. Patients at risk of developing gastroparesis may be found among those with nutritional difficulties before and during the transplant course.

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[13C]octanoic acid breath test for gastric emptying of solids: Accuracy, reproducibility, and comparison with scintigraphy

Cited by 186 publications

References 0 publications

Reliability of the time to maximal [<sup>13</sup>CO<sub>2</sub>] excretion and the half-[<sup>13</sup>CO <sub>2</sub>] excretion time as a gastric emptying parameter: Assessments using the Wagner-Nelson method

Reliability of the time to maximal [<sup>13</sup>CO<sub>2</sub>] excretion and the half-[<sup>13</sup>CO <sub>2</sub>] excretion time as a gastric emptying parameter: Assessments using the Wagner-Nelson method

Methods for measurement of gastric motility

Gastric emptying after autologous haemopoietic stem-cell transplantation: a prospective trial

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