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Clinical assessment of gastric emptying and sensory function utilizing gamma scintigraphy: Establishment of reference intervals for the liquid and solid components of the Nottingham test meal in healthy subjects

Parker, H. L.; Tucker, E.; Blackshaw, E.; Hoad, Caroline; Marciani, L.; Perkins, A.; Menne, D.; Fox, M.

Clinical assessment of gastric emptying and sensory function utilizing gamma scintigraphy: Establishment of reference intervals for the liquid and solid components of the Nottingham test meal in healthy subjects Thumbnail


Authors

H. L. Parker

E. Tucker

E. Blackshaw

CAROLINE HOAD CAROLINE.L.HOAD@NOTTINGHAM.AC.UK
Senior Research Fellow

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LUCA MARCIANI LUCA.MARCIANI@NOTTINGHAM.AC.UK
Professor of Gastrointestinal Imaging

A. Perkins

D. Menne

M. Fox



Abstract

Background: Current investigations of stomach function are based on small test meals that do not reliably induce symptoms and analysis techniques that rarely detect clinically relevant dysfunction. This study presents the reference intervals of the modular “Nottingham test meal” (NTM) for assessment of gastric function by gamma scintigraphy (GSc) in a representative population of healthy volunteers (HVs) stratified for age and sex.
Methods: The NTM comprises 400 mL liquid nutrient (0.75 kcal/mL) and an optional solid component (12 solid agar-beads (0 kcal). Filling and dyspeptic sensations were documented by 100 mm visual analogue scale (VAS). Gamma scintigraphy parameters that describe early and late phase Gastric emptying (GE) were calculated from validated models.
Key Results: Gastric emptying (GE) of the liquid component was measured in 73 HVs (male 34; aged 45±20). The NTM produced normal postprandial fullness (VAS ≥30 in 41/74 subjects). Dyspeptic symptoms were rare (VAS ≥30 in 2/74 subjects). Gastric emptying half-time with the Liquid- and Solid-component -NTM was median 44 (95% reference interval 28-78) minutes and 162 (144-193) minutes, respectively. Gastric accommodation was assessed by the ratio of the liquid-NTM retained in the proximal:total stomach and by Early phase emptying assessed by gastric volume after completing the meal (GCV0). No consistent effect of anthropometric measures on GE parameters was present. Conclusions and Inferences: Reference intervals are presented for GSc measurements of gastric motor and sensory function assessed by the NTM. Studies involving patients are required to determine whether the reference interval range offers optimal diagnostic sensitivity and specificity.

Journal Article Type Article
Acceptance Date May 5, 2017
Online Publication Date Jun 6, 2017
Publication Date 2017-11
Deposit Date Jul 5, 2017
Publicly Available Date Jul 5, 2017
Journal Neurogastroenterology and Motility
Print ISSN 1350-1925
Electronic ISSN 1365-2982
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 29
Issue 11
Pages e13122
DOI https://doi.org/10.1111/nmo.13122
Keywords gamma scintigraphy, gastric emptying, visceral sensitivity
Public URL https://nottingham-repository.worktribe.com/output/864830
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/nmo.13122/abstract

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