Isotope gastric emptying tests in clinical practice: expectation, outcome, and utility.

Galil, Maged Abdel; Critchley, M.; Mackie, C R

doi:10.1136/gut.34.7.916

Cited by 37 publications

(22 citation statements)

References 9 publications

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“…In a study assessing utility of gastric scintigraphy, ''the influence of the result of gastric emptying studies upon the subsequent clinical management'' was determined from hospital case reviews [34]. In descriptions of the utility of antroduodenal manometry, one study reviewed clinic records to determine the positive impact of testing defined as implying ''that the results of manometry helped to choose a specific treatment for the patient'', while a second used case records to determine positive outcomes defined as ''the outcome of the study resulted in alteration of the management of the patient, … prompted further medical investigation, or …resulted in referral to another specialist'' [35,36].…”

Section: Discussionmentioning

confidence: 99%

Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation

et al. 2011

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WMC testing defines localized and generalized transit delays with suspected gastroparesis, intestinal dysmotility, or slow transit constipation. Symptoms do not predict the results of WMC testing. WMC findings provide new diagnoses in >50%, may be discordant with conventional tests, and can influence management by changing treatments and eliminating needs for other tests. These findings suggest potential benefits of this method in suspected dysmotility syndromes and mandate prospective investigation to further define its clinical role.

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Section: Discussionmentioning

confidence: 99%

Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation

et al. 2011

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“…98 The results of gastric emptying scintigraphy reportedly do not influence clinical manage ment, perhaps as a consequence of the poor correlation between symptoms and gastric emptying rates. 99 Evidence, however, suggests that rate of gastric emptying does influence outcomes in diabetic patients with symptoms of gastroparesis. In diabetic patients, those with upper gastrointestinal symptoms and delayed gastric empty ing had more hospitalizations and outpatient clinic and emergency department visits than similarly symptomatic individuals with normal gastric emptying.…”

Section: Diagnosis Of Presumed Gastroparesismentioning

confidence: 97%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

103

110

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Gastroparesis is a prevalent condition that produces symptoms of delayed gastric emptying in the absence of physical blockage. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical disease, although some cases stem from autoimmune, paraneoplastic, neurologic or other conditions. Histologic examination of gastric tissues from patients with severe gastroparesis reveals heterogeneous and inconsistent defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal, and increased levels of inflammatory cells. Diagnosis is most commonly made by gastric emptying scintigraphy; however, wireless motility capsules and nonradioactive isotope breath tests have also been validated. A range of treatments have been used for gastroparesis including dietary modifications and nutritional supplements, gastric motor stimulatory or antiemetic medications, endoscopic or surgical procedures, and psychological interventions. Most treatments have not been subjected to controlled testing in patients with gastroparesis. The natural history of this condition is poorly understood. Active ongoing research is providing important insights into the pathogenesis, diagnosis, treatment and outcomes of this disease.

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“…In a retrospective analysis of 375 patients undergoing gastric scintigraphy, determination of the rate of gastric emptying did not influence therapies offered to patients with possible gastric dysmotility. 17 Other tests of gastrointestinal function are performed in selected academic centers. Electrogastrography (EGG) measures gastric slow wave activity using cutaneous electrodes placed over the stomach and has been proposed to evaluate patients with unexplained nausea and vomiting to provide a possible pathophysiologic explanation for symptoms when therapy is ineffective or when gastric scintigraphy is q 2005 Lippincott Williams & Wilkins nondiagnostic.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Nausea, Gastroparesis, and Aerophagia

Hasler

2005

Journal of Clinical Gastroenterology

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Nausea, gastroparesis, and aerophagia are gastrointestinal phenomena that have variable impact on affected patients. The causes of nausea are varied; treatment of these conditions relates to the underlying etiology. Antiemetic agents acting on several distinct receptor subtypes produce benefits in distinct patient subsets. Gastroparesis is characterized by delays in gastric emptying, usually defined scintigraphically. Standard care of gastroparesis relies on dietary modification, antiemetic drug therapy, and initiation of medications that stimulate gastric motor activity. Recent advances include pyloric injection of botulinum toxin and surgical implantation of an electrical neurostimulator. Other surgical therapies are reserved for refractory cases. Aerophagia presents in individuals of normal and impaired cognitive function, most commonly with symptoms of overdistension or eructation. There are no pharmaceutical remedies for this condition; thus, therapy relies on behavioral treatments.

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Isotope gastric emptying tests in clinical practice: expectation, outcome, and utility.

Cited by 37 publications

References 9 publications

Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation

Generalized Transit Delay on Wireless Motility Capsule Testing in Patients with Clinical Suspicion of Gastroparesis, Small Intestinal Dysmotility, or Slow Transit Constipation

Gastroparesis: pathogenesis, diagnosis and management

Nausea, Gastroparesis, and Aerophagia

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