Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms

Cifuentes, Juan D. Gomez; Radetic, Mark; Gabbard, Scott

doi:10.14309/00000434-201810001-01193

Cited by 7 publications

(13 citation statements)

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“…Nearly, two-thirds of patients with rapid GE had one or more extra-intestinal complication of DM. Reaffirming earlier observations, in this study (a) weight loss was associated with a lower risk of rapid versus normal GE, 6 (b) the phenotype (ie, type of DM, prevalence of complications) did not discriminate between patients with normal and rapid GE,6,10,11,48 and (c) insulin therapy was associated with a lower risk of rapid (versus normal GE) 6. Insulin reverses the reduced expression of neuronal nitric oxide synthase (nNOS), which should improve gastric accommodation and gastric emptying, in diabetic mice [12][13][14][15].…”

supporting

confidence: 87%

“…Although we used more stringent criteria to define rapid GE and excluded patients who had prior gastric surgery, this proportion is comparable to the prevalence (ie, 10% of 750 patients, 9% of 545 patients, and 9% of 2907 patients) in earlier reports that included patients who had gastric surgery. 3,10,28 In another study, 28% of 642 patients undergoing scintigraphy had rapid GE, perhaps because a less stringent criterion was used to define rapid GE (ie, gastric half-emptying time less than 70 minutes). 29 Nearly, one-third of patients with rapid GE1 had nausea and/or vomiting, perhaps because rapid delivery of nutrients distends and Only insulin therapy* 89 (59) 9 (33)…”

Section: Discussionmentioning

confidence: 99%

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Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Kuwelker

Muthyala

O’Connor

et al. 2020

Neurogastroenterology Motil

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Aims Some patients with upper gastrointestinal symptoms have rapid gastric emptying (GE). We aimed to compare patients with normal and rapid GE and to identify phenotypes among patients with rapid GE. Methods Among 2798 patients who underwent GE scintigraphy, we compared patients with normal and rapid GE and separately, patients with rapid GE at 1 hour (GE1), 2 hours (GE2), or both (GE12). Results In 2798 patients, GE was normal (74%), delayed (18%), or rapid (8%). Among 211 patients with rapid GE, patterns were rapid GE1 (48%), 2 hours (17%), or 1 and 2 hours (35%); 42 (20%) had diseases that explain rapid GE. A combination of upper and lower gastrointestinal symptoms (54%) was more common that isolated upper (17%) or lower (28%) gastrointestinal symptoms (P < .001). Constipation was more prevalent in patients with rapid GE 2 (72%) than rapid GE 1 (47%) or rapid GE12 hours (67%) (P < .05). Among 179 diabetes mellitus (DM) patients, 15% had rapid GE, which was not associated with the DM phenotype. By multivariable analysis, insulin therapy (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.15‐0.88), and weight loss (OR, 0.10; 95% CI, 0.01‐0.78) were associated with a lower risk of rapid than normal GE in DM. Conclusions Eight percent of patients undergoing scintigraphy had rapid GE, which is most frequently associated with upper and lower gastrointestinal symptoms; constipation is common. Insulin therapy and weight loss were associated with a lower risk of rapid than normal GE in DM patients.

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supporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Kuwelker

Muthyala

O’Connor

et al. 2020

Neurogastroenterology Motil

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“…Rapid gastric emptying can also occur in POTS patients and was noted to occur more frequently than delayed gastric emptying in one study 20 . Symptoms of rapid gastric emptying are similar to those of gastroparesis during the first hour of food ingestion, which include nausea, vomiting, early satiety, and abdominal pain 19,25 …”

Section: Management Of Gi Symptoms In Potsmentioning

confidence: 95%

“…17 Rapid gastric emptying can also occur in POTS patients and was noted to occur more frequently than delayed gastric emptying in one study. 20 Symptoms of rapid gastric emptying are similar to those of gastroparesis during the first hour of food ingestion, which include nausea, vomiting, early satiety, and abdominal pain 19,25 No studies have specifically looked at managing GI symptoms in POTS patients with rapid gastric emptying but based on studies from post-surgical patients with dumping syndrome, diet modification should be first line of therapy, which will be discussed below.…”

Section: Nausea and Vomitingmentioning

confidence: 99%

“…This association suggests that patients with hypovolemic POTS are more likely to exhibit rapid gastric emptying. It is unclear why these patients with POTS have this pattern of gastric emptying, but rapid gastric emptying can also cause GI symptoms similar to those associated with gastroparesis such as nausea, vomiting, and weight loss 19,25 …”

Section: Mechanisms Of Gi Symptoms In Potsmentioning

confidence: 99%

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Mechanisms and management of gastrointestinal symptoms in postural orthostatic tachycardia syndrome

Abell

Raj

et al. 2020

Neurogastroenterology Motil

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Postural orthostatic tachycardia syndrome (POTS) is defined as a disorder with symptoms of orthostatic intolerance associated with an increase in heart rate by at least 30 beats per minute without orthostatic hypotension within 10 minutes of standing. These symptoms of orthostatic intolerance must also improve upon sitting or assuming a supine position. 1 Table 1 details the diagnostic criteria of POTS. These criteria are important because not all patients with symptoms of orthostatic intolerance meet the definition of POTS as POTS represents one of many conditions in a spectrum of autonomic disorders associated with symptoms of orthostatic intolerance. Nevertheless, POTS is prevalent and estimated to affect 0.3 to 3 million people in the United States 2 with a preponderance in young females between ages 15-45 years old. 3 The pathophysiology of POTS is complex but revolves around 3 central pathophysiologic mechanisms: persistent predilection for hypovolemia, partial autonomic neuropathy, and hyperadrenergic state. 4 It is important to understand that these endophenotypes are not mutually exclusive as some patients may exhibit characteristics from two or more of these pathophysiological mechanisms simultaneously. POTS is also associated with many comorbid conditions such as chronic fatigue syndrome, fibromyalgia, migraine headaches, median arcuate ligament syndrome (MALS), mast cell activation syndrome (MCAS), celiac disease and gluten sensitivity, and the hypermobile form of Ehlers-Danlos syndrome (hEDS). 5-7 The vast majority of POTS patients have at least one gastrointestinal (GI) symptom (>90%), with the most common symptoms being nausea, abdominal pain, and bloating. 8-10 The vast majority of hEDS patients also have GI symptoms. 11 When POTS and hEDS present concomitantly in the

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The [¹³C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling

Gerichten

Elnesr

Prollins

et al. 2022

Lipids

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Gastric emptying (GE) is the process of food being processed by the stomach and delivered to the small intestine where nutrients such as lipids are absorbed into the blood circulation. The combination of an easy and inexpensive method to measure GE such as the CO2 breath test using the stable isotope [13C]octanoic acid with semi‐mechanistic modeling could foster a wider application in nutritional studies to further understand the metabolic response to food. Here, we discuss the use of the [13C]octanoic acid breath test to label the solid phase of a meal, and the factors that influence GE to support mechanistic studies. Furthermore, we give an overview of existing mathematical models for the interpretation of the breath test data and how much nutritional studies could benefit from a physiological based pharmacokinetic model approach.

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Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms

Cited by 7 publications

References 0 publications

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Mechanisms and management of gastrointestinal symptoms in postural orthostatic tachycardia syndrome

The [¹³C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling

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Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms

Cited by 7 publications

References 0 publications

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Mechanisms and management of gastrointestinal symptoms in postural orthostatic tachycardia syndrome

The [13C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling

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The [¹³C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling