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Gastric function in diabetic gastroparesis assessed by ultrasound and scintigraphy
Author(s) -
Steinsvik Elisabeth K.,
Sangnes Dag A.,
Søfteland Eirik,
Biermann Martin,
Assmus Jörg,
Dimcevski Georg,
Gilja Odd Helge,
Hausken Trygve
Publication year - 2022
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.14235
Subject(s) - gastroparesis , medicine , gastric emptying , scintigraphy , stomach , antrum , gastroenterology , diabetes mellitus , ultrasound , radiology , endocrinology
Abstract Background Gastroparesis is a severe diabetes complication characterized by delayed gastric emptying. We examined patients with symptoms of diabetic gastroparesis using gastric emptying scintigraphy and ultrasound drink test. The primary aim was to investigate how ultrasound could provide information about gastric motility features in diabetic gastroparesis. Material and methods We prospectively included 58 patients with diabetes (48 type 1) with symptoms of gastroparesis and 30 healthy controls. Patients were examined with ultrasound of the stomach in a seated position after drinking 500 ml low‐caloric meat soup, at the same time recording dyspeptic symptoms. The following day, they were examined with gastric emptying scintigraphy, defining gastroparesis as >10% retention after 4 h. Key Results We found motility disturbances in the proximal stomach measured by ultrasound in patients with diabetic gastroparesis. A linear mixed effects model including repeated ultrasound measurements revealed a slower decrease of the proximal stomach size in gastroparesis compared to healthy controls ( p < 0.01), and the proximal diameter at 20 min was correlated to scintigraphy at 4 h ( r = 0.510, p = 0.001). The antrum in patients with diabetic gastroparesis was twice as large compared to healthy controls ( p = 0.009), and fasting antral size was correlated to gastric emptying scintigraphy ( r = 0.329, p = 0.013). Both diabetes patients with and without gastroparesis had impaired accommodation ( p = 0.011). Conclusions and Inferences On ultrasound, we found delayed reduction of proximal stomach size and impaired accommodation after a liquid meal in patients with gastroparesis, emphasizing the role of the proximal stomach. Furthermore, we found antral distention in gastroparesis patients.