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Clinical characteristics associated with idiopathic rapid gastric emptying in patients referred for gastric emptying studies
Author(s) -
Xiao Ted,
Koch Kenneth,
Bones Brent,
Urbain JeanLuc Claude,
Bennett Paige,
Rejeski Jared
Publication year - 2021
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12990
Subject(s) - medicine , gastric emptying , gastroparesis , gastroenterology , palpitations , vomiting , nausea , bloating , abdominal pain , diarrhea , stomach
Objectives Rapid gastric emptying (RGE) is diagnosed using nuclear medicine gastric emptying scintigraphy (GES). The clinical symptoms are non‐specific and its pathophysiology in the absence of gastric surgery is poorly understood. We aimed to evaluate the clinical characteristics associated with idiopathic RGE. Methods GES studies were reviewed from a database of 1958 4‐hour solid‐phase GES performed over an 8‐year period. RGE was defined as <30% of the test meal remaining in the stomach at 1 hour. Patients who had had any gastric operation were excluded. A chart review was conducted to extract patients’ baseline data and clinical characteristics. Results Of the 1958 GES studies reviewed, 156 (8.0%) patients had RGE, and 534 (27.3%) had delayed gastric emptying (>10% retained food at 4 h), respectively. Idiopathic RGE constituted 22.6% (156/690) of all abnormal GES studies. The patients’ average age at diagnosis was 54.0 years and 53.8% of patients with RGE were female. Most (69.2%) of these studies were ordered with an initial clinical suspicion of gastroparesis, compared with only 12.2% with a suspicion of RGE. Among this idiopathic RGE cohort, 71.2% presented with symptoms of nausea, 42.9% with vomiting, 32.1% with abdominal pain, 21.2% with bloating and 17.9% with early satiety. Only 7.7% presented with diarrhea, 0.6% with palpitations and 0.6% with hypoglycemia. Conclusions Idiopathic RGE is an important differential diagnosis in patients with symptoms classically associated with gastroparesis. Few have postprandial diarrhea or palpitations as their presenting symptom. Further studies of idiopathic RGE syndrome are warranted.