Gas2 Accelerated gastric emptying: Clinical value and its relationship to age and gender. (Gastroenterology).

GAS2 ACCELERATED GASTRIC EMPTYING: CLINICAL VALUE AND ITS RELATIONSHIP TO AGE AND GENDER. Amolak Singh, MD, and Rubin J. Singh. University of Missouri Health Sciences Center, Columbia, Mo.

Accelerated gastric emptying is known to occur in patients (pts) with partial gastrectomy or peptic ulcer disease. However, most pts with accelerated gastric emptying do not have these conditions. Moreover, the relationship of this phenomenon to age and gender has not been elucidated. In this study, we determined the frequency of this phenomenon, its relationship to age and sex, and its clinical value in pts referred for gastric emptying studies (GES). The review included 750 pts who had undergone scintigraphic GES over last 10 years. A subset of 80 pts with gastric emptying time (GET) <35 minutes (defined as accelerated gastric emptying) were included in this analysis, Using statistical methods (Z-test) the mean GET of female pts was compared with mean GET of male pts. Similarly, the mean GET in young (<50 years) pts was compared with older (>50 years) pts. The clinical indication and symptoms that prompted GES were noted. The GET was determined using a standardized radiolabeled egg meal with in-house establ ished normal emptying half time range of 35-100 minutes (mean [+ or -] SD). The GET was calculated from decay corrected mean geometric gastric counts, using linear regression analysis. Accelerated gastric emptying was found in 10.7% (80/750) of patients referred for GES. The mean age and GET of pts with this phenomenon were 54 [+ or -] 19.5 years and 26.7 [+ or -] 5.9 minutes respectively. This phenomenon was equally common in both sexes (P = .328). The mean age and GET in females were 52.8 [+ or -] 20.8 years, and 26.9 [+ or -] 5.5 minutes respectively. The mean age and GET in males were 56 [+ or -] 17.4 years, and 26.3 [+ or -] 6.6 minutes respectively. Younger pts (mean age, 34.3 [+ or -] 9.5) and older (mean age, 67.3 [+ or -] 11.6) had similar (P = .10) GET of 27.75 [+ or -] 5.9, and 26 [+ or -] 5.8 respectively. Most patients presented with nonspecific symptoms such as nausea, vomiting, abdominal pain, and early satiety. The GET studies were ordered to exclude gastroparesis. The underlying disease proce ss was unidentified in most pts,] 9 had diabetes. Only one had peptic ulcer, none had gastric resection. The accelerated gastric emptying is equally common in young and old individuals, and pts of both sexes. Most patients with accelerated gastric emptying present with symptoms that mimic gastroparesis. We believe, this phenomenon may be representative of early dumping syndrome (EDS) in most patients. The GES contribute by making a clear distinction between EDS and gastroparesis, and help directing appropriate therapy. Pts with EDS are usually treated with dietary modifications; whereas pts with gastroparesis respond well to prokinetic therapy.