During a 2 year period, 83 patients with gastric motility problems were evaluated using
radionuclide imaging. The patients presented with epigastric distress, postprandial fullness,
pain,
nausea,
vomiting, and
diarrhea; signs and symptoms suggestive of either
gastroparesis or
gastric outlet obstruction. Upper gastrointestinal series or endoscopy, or both, demonstrated no mechanical obstruction. After
oral administration of
a 300 g meal labeled with 600 muCi of technetium-99m
sulfur colloid, a gastric emptying study consisting of serial images and data acquisition was performed. Of the patients studied, 52 had had
peptic ulcer surgery, 17 were suspected of having
gastroesophageal reflux, 8 were diabetic and suspected of having visceral enteropathy, and 6 had a history of
irritable bowel syndrome. The normal mean gastric half emptying time was 77 +/- 16 minutes. Of the patients who had had gastric surgery, 90.4 percent had abnormal emptying: 69.2 percent had delayed gastric emptying and 21.2 percent had rapid gastric emptying time; 9.6 percent had normal emptying time. Of the
gastroesophageal reflux group, all but two had normal gastric emptying time; 65 percent demonstrated
gastroesophageal reflux within 15 minutes. Two of the patients with
irritable bowel syndrome had prolonged emptying; the rest had normal emptying. All diabetic patients with
gastroparesis had prolonged gastric emptying time, and all responded favorably to
metoclopramide. Of the patients who previously had
peptic ulcer surgery and had prolonged emptying time, 72 percent also responded favorably to
metoclopramide. We conclude that
radionuclide gastric imaging is a useful diagnostic test for the measurement of gastric emptying in patients with a variety of gastrointestinal motility disorders and may be helpful in assessing medical
therapy and selecting those who may be candidates for surgery.