A Gluten-Free Vegan Meal for Gastric Emptying Scintigraphy

Somasundaram, Vijay Harish; Subramanyam, Padma; Palaniswamy, Shanmuga Sundaram

doi:10.1097/rlu.0000000000000549

Cited by 19 publications

(7 citation statements)

References 11 publications

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“…Rice idli meal is easy to prepare, has the advantage of being gluten-free and has been established as a solid test meal for GES in earlier Indian studies. [ 17 19 ] Though guidelines recommend continuing GES study up to 4h,[ 13 18 ] we could not extend the study for 4h because of small meal size, faster GE for rice idli meal and logistic constraints. Faster GE for rice idli meal in the present study, compared to egg white-bread meal,[ 13 18 ] can be explained based on the lower protein content in the former.…”

Section: Discussionmentioning

confidence: 99%

Delayed gastric emptying among Indian patients with non-diabetic chronic kidney disease

et al. 2021

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Introduction: Upper gastrointestinal symptoms such as nausea, vomiting, abdominal bloating, and poor appetite are more frequent among chronic kidney disease (CKD) patients and may contribute to poor nutritional intake and malnutrition. Delayed gastric emptying (GE), one of the important contributors to these symptoms, has not been evaluated systematically in different stages of non-diabetic CKD, among Indian patients. Materials and Methods: This hospital-based, cross-sectional analytical study aimed to find out the frequency of delayed GE in non-diabetic CKD (stages: 3,4,5) patients and also to study the correlation between delayed GE and symptoms of gastroparesis, autonomic neuropathy and nutritional parameters. Patients were subjected to evaluation of symptoms of gastroparesis by standardized questionnaire (gastroparesis cardinal symptom index), nutritional status (by anthropometric measures and serum albumin), autonomic function by heart rate variability (HRV) and GE by gastric scintigraphy with a standardized solid rice idli (savory cake) meal labeled with technetium-99m sulfur colloid. Results: Of the 89 non-diabetic CKD (stages-3,4,5) patients evaluated, 22 (≈25%) had delayed GE and 8 (≈9%) rapid GE. Prevalence of delayed GE was higher among stage 5 (15/49, 31%) compared to stages 3 and 4 (7/40, 17.5%), though the difference was statistically insignificant. There was no association between delayed GE and symptoms of gastroparesis and autonomic neuropathy. Though not statistically significant, nutritional parameters (body mass index, skinfold thickness, and serum albumin) were poorer in the delayed GE group compared to the rest. Conclusion: Delayed GE, irrespective of symptoms, may contribute to malnutrition and hence should be looked for in non-diabetic CKD patients with unexplained malnutrition.

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Section: Discussionmentioning

confidence: 99%

Delayed gastric emptying among Indian patients with non-diabetic chronic kidney disease

et al. 2021

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“…They also found that more than 96% of the sulfur colloid was bound to the meal at 4 h of suspension in simulated gastric fluid and concluded that radiolabeled Idli meal is a good alternative to egg white sandwich. [5] Indian Round breads (Chapati) has also been standardized in the study by Awasthi et al, results of which showed ~90% of the radiolabel remained bound to the solid phase at 3 h at all pH levels. [14] Both Idli and Chapati are widely acceptable meals in India.…”

Section: Discussionmentioning

confidence: 99%

“…The total energy of the meal was approximately 350 kcal. [4,5] The present study was carried out for a total duration of 4 h with image acquisition done for 1 min-anterior and posterior views. The images were acquired: immediately after ingestion of meal, 30 min, 1 h, 2 h, and 4 h after meal using GE NMCT 670 (integrated SPECT/CT-single photon emission computed tomography by GE Healthcare, Chicago, USA) dual-headed gamma camera with 140 keV Tc-99 m photopeak with 20% window (140keV ± 10%).…”

Section: Methodsmentioning

confidence: 99%

Comparison of gastric motility in patients of type 2 diabetes mellitus with various degrees of glycemic control

et al. 2021

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The aim of this study was to evaluate the effect of glycemic control as estimated by glycated hemoglobin A1c (HbA1c) on gastric emptying in patients with type 2 diabetes mellitus (DM) using gastric emptying scintigraphy (GES). This was a cross-sectional study conducted at a tertiary health care center in Northern India. The study included 44 patients who underwent GES using a radiolabeled solid Idli meal containing 1 mCi of Tc-99 m Sulfur Colloid. Patients were divided into three groups based on glycemic control as Group A, B, and C with HbA1c <7%, 7%–9%, and >9%. Statistical analysis was performed using the IBM® SPSS® Statistics Version 23.0 The comparison of proportions was done using the Chi-square test and Fisher's exact test. Means were compared using the independent t-test and one-way analysis of variance. P < 0.05 was considered statistically significant. No statistically significant correlation was found between delayed gastric emptying and glycemic control ( P = 0.09), gender ( P = 0.228), dietary patterns ( P = 0.91), symptoms of gastroparesis ( P = 0.06), body mass index (BMI) ( P = 0.267), and duration of type 2 DM ( P = 0.565). No statistically significant association was also found between glycemic control and time taken for half gastric emptying (t1/2) ( P = 0.225). Scintigraphy using Tc-99m Sulfur Colloid radiolabeled Idli meal can be effectively used for the assessment of gastric emptying. There is no significant correlation of delayed gastric emptying with glycemic control, gender, BMI, type of diet, and duration of diabetes mellitus.

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“…Somasundaram et al have suggested a gluten-free vegan meal for patients with dietary restrictions. Their findings are promising [23,24,25]. Despite its accuracy and conditions similar to the physiological findings, their diagnostic examination is not commonly used due to considerable costs.…”

Section: Description Of the State Of Knowledgementioning

confidence: 90%

Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis , diagnosis, treatment and complications

Kuzemko¹,

Rymarz²,

Prystupa³

et al. 2017

J Pre Clin Clin Res.

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Introduction. Late complications of diabetes mellitus are a serious challenge for physicians treating diabetic patients. Micro-and macro-angiopathic changes are of the most severe sequels. However, it should be remembered that the effects of long-term diabetes are also associated with changes in the peripheral nervous system. One of the complications most troublesome for patients is diabetic autonomic neuropathy of the gastrointestinal (GI) tract. Objective. The review article presents the pathogenesis of diabetic neuropathy of the autonomous gastrointestinal tract, and advances in the diagnosis and treatment of this disease. The study used materials in the database which demonstrate current standards of conduct, based on the principles of EBM. Brief description of the state of knowledge. Diabetic neuropathy is one of the most common complications of diabetes mellitus. According to epidemiologists, it affects 10% to even 100% of patients with long-standing disease. Damage to the nervous fibres mainly results from hyperglycaemia, which leads to the typical symptoms of dysfunction of GI tract segments. The main additional examinations include abdominal ultrasound (US) and abdominal X-ray. In cases with oesophageal disorders accompanied by dysphagia, gastroscopy is found useful for excluding possible neoplastic lesions. The gold standard for evaluation of gastric emptying is radioisotopic scintigraphy, however it is available only in some specialistic departments. Other recommended methods include: manometry, EGG, insulin tests, NMR and expiratory tests. To date, the problem has been managed symptomatically; in special cases, surgical interventions have been required. Conclusions. At present, a wide array of treatment options is available, including new forms of drugs and less radical surgical procedures carried out in numerous centres worldwide.

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A Gluten-Free Vegan Meal for Gastric Emptying Scintigraphy

Abstract: Radiolabeled idli meal is a good alternative to EWS meal for routine GES, especially among patients with specific dietary restrictions.

Cited by 19 publications

References 11 publications

Delayed gastric emptying among Indian patients with non-diabetic chronic kidney disease

Delayed gastric emptying among Indian patients with non-diabetic chronic kidney disease

Comparison of gastric motility in patients of type 2 diabetes mellitus with various degrees of glycemic control

Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis , diagnosis, treatment and complications

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