scholarly journals Using gastric emptying scintigraphy to evaluate antral contractions and duodenal bolus propagation

2020 ◽  
Vol 318 (1) ◽  
pp. G203-G209
Author(s):  
Perry Orthey ◽  
Simin Dadparvar ◽  
Bhishak Kamat ◽  
Henry P. Parkman ◽  
Alan H. Maurer
Keyword(s):  
Gastric Emptying ◽  
Region Of Interest ◽  
Sulfur Colloid ◽  
Gastric Emptying Scintigraphy ◽  
Gastrointestinal Dysmotility ◽  
Static Images ◽  
Unexplained Symptoms ◽  
Meal Ingestion ◽  
Dynamic Scintigraphy ◽  
Upper Gastrointestinal

Our aim was to investigate the feasibility of measuring antral contractions and duodenal bolus propagation (DBP) during dynamic antral contraction scintigraphy (DACS) as an assessment of antro-pyloro-duodenal coordination (APDC). Gastric emptying scintigraphy (GES) with DACS was performed with Tc-99m sulfur colloid (SC) using increasing doses of 74 MBq (2 mCi) for 10 subjects, 185 MBq (5 mCi) for 11, and 370 MBq (10 mCi) for 11. DACS was performed for 10 min after static images at 0, 30, 60, 120, 180, and 240 min in anterior and right anterior oblique (RAO) projections. Best projection and lowest dose of Tc-99m SC were assessed visually. DBP were quantified utilizing duodenal activity peaks from a region of interest in the first portion of the duodenum. DBP was better visualized in the RAO projection than anterior projection and using 185 MBq (5 mCi) and 370 MBq (10 mCi) compared with 74 MBq (2 mCi). DBP showed infrequent and irregular bolus transfers from the antrum to the duodenum. Antral activity peaks at 60 min averaged 2.91 ± 0.66 per minute and duodenum bolus peaks 0.36 ± 0.18 per minute (ratio 0.36/2.91 = 0.12). DBP activity peaks can be measured during GES with DACS but requires a 185-MBq (5 mCi) dose of Tc-99m SC radiolabeled test meal for adequate DBP signal detection and is better imaged in RAO than anterior projection. DBPs over the first 60 min postmeal ingestion are infrequent with only 12% of the antral contractions propagating into the duodenum. This methodology appears promising to assess APDC. NEW & NOTEWORTHY This study shows that duodenal bolus propagations after meal ingestion can be measured during gastric emptying scintigraphy using dynamic scintigraphy. Duodenal bolus propagation over the first 60 min postmeal ingestion are infrequent with only 12% of the antral contractions propagating into the duodenum. This methodology appears promising to assess antropyloroduodenal coordination in patients with unexplained symptoms of upper gastrointestinal dysmotility.

scholarly journals Impaired ghrelin signaling is associated with gastrointestinal dysmotility in rats with gastroesophageal reflux disease

2012 ◽  
Vol 303 (1) ◽  
pp. G42-G53 ◽  
Author(s):  
Miwa Nahata ◽  
Shuichi Muto ◽  
Nobuhiko Oridate ◽  
Shunsuke Ohnishi ◽  
Koji Nakagawa ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Food Intake ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Gastrointestinal Motility ◽  
Reflux Disease ◽  
Gastrointestinal Dysmotility ◽  
Antral Motility ◽  
Gastroduodenal Motility ◽  
Upper Gastrointestinal

Gastroesophageal reflux disease (GERD) is often associated with decreased upper gastrointestinal motility, and ghrelin is an appetite-stimulating hormone known to increase gastrointestinal motility. We investigated whether ghrelin signaling is impaired in rats with GERD and studied its involvement in upper gastrointestinal motility. GERD was induced surgically in Wistar rats. Rats were injected intravenously with ghrelin (3 nmol/rat), after which gastric emptying, food intake, gastroduodenal motility, and growth hormone (GH) release were investigated. Furthermore, plasma ghrelin levels and the expression of ghrelin-related genes in the stomach and hypothalamus were examined. In addition, we administered ghrelin to GERD rats treated with rikkunshito, a Kampo medicine, and examined its effects on gastroduodenal motility. GERD rats showed a considerable decrease in gastric emptying, food intake, and antral motility. Ghrelin administration significantly increased gastric emptying, food intake, and antral and duodenal motility in sham-operated rats, but not in GERD rats. The effect of ghrelin on GH release was also attenuated in GERD rats, which had significantly increased plasma ghrelin levels and expression of orexigenic neuropeptide Y/agouti-related peptide mRNA in the hypothalamus. The number of ghrelin-positive cells in the gastric body decreased in GERD rats, but the expression of gastric preproghrelin and GH secretagogue receptor mRNA was not affected. However, when ghrelin was exogenously administered to GERD rats treated with rikkunshito, a significant increase in antral motility was observed. These results suggest that gastrointestinal dysmotility is associated with impaired ghrelin signaling in GERD rats and that rikkunshito restores gastrointestinal motility by improving the ghrelin response.

scholarly journals Role of Gastric Emptying in Symptoms of Gastroparesis

2019 ◽  
Vol 1 (4) ◽  
pp. 391-402 ◽  
Author(s):  
Asad Jehangir ◽  
Henry P. Parkman
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Gastrointestinal Symptoms ◽  
Colonic Transit ◽  
Distal Stomach ◽  
Postprandial Fullness ◽  
Gastrointestinal Dysmotility ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal

The symptoms of gastroparesis, such as nausea, vomiting, postprandial fullness, early satiety and abdominal pain, frequently impair the quality of life of the affected individuals. The diagnosis of gastroparesis is made after structural etiologies are ruled out and an assessment of gastric function shows delayed gastric emptying. The role of the delay in gastric emptying in the pathogenesis of symptoms of gastroparesis has been debated, with some studies suggesting an association between delayed gastric emptying and the upper gastrointestinal symptoms, while others do not. The recent literature supports the importance of using reliable methods to assess gastric emptying, as delay in gastric emptying measured on a reliable test (4-h scintigraphy or breath test) is associated with the severity of upper gastrointestinal symptoms. In addition to measuring total gastric emptying, evaluation of regional gastric retention in the proximal and distal stomach and whole gut transit to assess small intestinal and colonic transit may provide additional useful information in patients with more generalized symptoms of gastrointestinal dysmotility.

Mo1295 Symptoms Following Meal Ingestion During Gastric Emptying Scintigraphy in Patients With Gastroparesis

2014 ◽  
Vol 146 (5) ◽  
pp. S-611
Author(s):  
Akil Hassam ◽  
Saraswathi Arasu ◽  
Zubair A. Malik ◽  
Alan H. Maurer ◽  
Henry P. Parkman
Keyword(s):  
Gastric Emptying ◽  
Gastric Emptying Scintigraphy ◽  
Meal Ingestion

Impact of methodical guidelines of gastric scintigraphy on patients’ radiation exposure

2021 ◽  
Vol 75 (2) ◽  
pp. 159-164
Author(s):  
Martina Horváthová ◽  
Zuzana Bárdyová ◽  
Darina Budošová ◽  
Rastislav Husťak
Keyword(s):  
Gastric Emptying ◽  
Radiation Exposure ◽  
Gold Standard ◽  
Retrospective Cohort ◽  
Noninvasive Method ◽  
Lower Intensity ◽  
Medicine Department ◽  
Nuclear Medicine Department ◽  
Gastric Emptying Scintigraphy ◽  
Gastric Scintigraphy

Introduction: Gastric emptying scintigraphy (GES) is a safe, noninvasive method for assessing the ability of the stomach to empty which has been used clinically for many years. It is considered as a “gold standard” to assess gastric emptying of both solids and liquids allowing assessment of early, mid and late emptying, each of which may be altered by pathology. The aim of the study was to analyse standard diagnostic approach and evaluate patients` radiation exposure, who underwent GES in Slovakia. Methods: A retrospective cohort study included 55 patients from 2 departments of nuclear medicine (department A, B). Patients’ radiation exposure was determined by dosimetry program IDAC-Dose2.1. The radiopharmaceutical 99mTc-DTPA, always with the same activity, was applied orally to patients at Department B. The applied activity of the radiopharmaceutical at GES was 185 MBq. The radiopharmaceutical 99mTc MAA, with various activity, was applied orally to patients at Department A. Results: According to ICRP60, the eff ective dose (ED) of every patient undergoing GES was 0.77 mSv and, according to ICRP103, the dose was 0.836 mSv at Department B. Patients at Department A were exposed to ionizing radiation with 5-times lower intensity, compared with patients at Department B. It was caused by radiopharmaceutical activity correction. The ED medians according to ICRP60, and according to ICRP103 were 0.167 mSv (range 0.105–0.208 mSv) and 0.181 mSv (range 0.113–0.226 mSv) at Department A, respectively. Discussion: Adequate correction of applied radiopharmaceutical activity is an essential part of GES guidelines and in accordance with ALARA principles. For the accuracy of GES examination, it is necessary to follow a standard 4-hour protocol and an approach which ensures full-featured utilization of the examination while decreasing patient`s radiation exposure. Conclusion: The results of our study show relatively low ED associated with GES, but also confi rm that the GES methodology significantly affects the patient`s radiation exposure

scholarly journals Gfral-expressing Neurons Suppress Food Intake via Aversive Pathways

2020 ◽  
Author(s):  
Paul V. Sabatini ◽  
Henriette Frikke-Schmidt ◽  
Joe Arthurs ◽  
Desiree Gordian ◽  
Anita Patel ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Food Intake ◽  
Taste Aversion ◽  
Conditioned Taste Aversion ◽  
Mechanisms Of Action ◽  
Parabrachial Nucleus ◽  
Gastric Physiology ◽  
Anorexigenic Peptide ◽  
Artificial Activation ◽  
Meal Ingestion

AbstractTo determine the function and mechanisms of action for hindbrain neurons that express GFRAL, the receptor for the anorexigenic peptide, GDF-15, we generated Gfralcre and conditional GfralCreERT mice. While signals of infection or pathophysiologic states (rather than meal ingestion) stimulate GFRAL neurons, the artificial activation of GfralCre- expressing neurons inhibited feeding, decreased gastric emptying, and promoted a conditioned taste aversion (CTA). Additionally, activation of the smaller population of GFRAL neurons captured by the GfralCreERT allele decreased gastric emptying and produced a CTA without suppressing food intake, suggesting that GFRAL neurons primarily modulate gastric physiology and stimulate aversive responses. GFRAL neurons most strongly innervated the parabrachial nucleus (PBN), where they targeted CGRP-expressing (CGRPPBN) neurons. Silencing CGRPPBN neurons abrogated the aversive and anorexic effects of GDF-15. These findings suggest that GFRAL neurons link non-meal-associated, pathophysiologic signals to the aversive suppression of nutrient uptake and absorption.

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