Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms
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Rapid gastric emptying (RGE) is defined as less than 30% retention at 1 h of solid meal ingestion. It is unclear whether RGE represents a separated clinical entity or part of the functional dyspepsia spectrum.
To determine clinical predictors of RGE in patients presenting with dyspeptic symptoms.
Retrospective study of patients who underwent solid Gastric Emptying Scintigraphy to evaluate dyspeptic symptoms from January 2011 to September 2012. Patients with delayed gastric emptying (> 10% gastric retention at 4 h) or prior gastric surgery were excluded. Patients with RGE were compared to those with normal gastric emptying (NGE) in a patient ratio of 1:3. Demographic data, symptoms, comorbidities, surgeries, endoscopy findings, medications, HbA1c, and TSH were analyzed. Univariate and multivariate logistic regression analyses were performed.
A total of 808 patients were included, 202 patients with RGE and 606 patients with NGE. Mean gastric retention at 1 h was 18% [12.0, 24.0] and 65% [52.0, 76.0], respectively. Patient with RGE were more likely to present with nausea/vomiting (OR 2.4, p < 0.001), weight loss (OR 1.7, p = 0.008), and autonomic symptoms (OR 2.8, p = 0.022). Identified clinical predictors of RGE were older age (OR 1.08 [1.01, 1.1], p = 0.018), male gender (OR 2.0 [1.4, 2.9], p ≤ <0.001), higher BMI (OR 1.03 [1.00, 1.05], p = 0.018), diabetes (OR 1.8 [1.2, 2.7], p = 0.05), and fundoplication (OR 4.3 [2.4, 7.7], p ≤ 0.001).
RGE represents a distinct population among patients presenting with dyspepsia in whom fundoplication, diabetes, and male gender were the strongest clinical predictors. RGE was significantly associated with nausea/vomiting, weight loss, and autonomic symptoms.
KeywordsRapid gastric emptying Functional dyspepsia Dyspepsia Gastric emptying scintigraphy Fundoplication Diabetes mellitus
Rapid gastric emptying
Normal gastric emptying
Body mass index
Gastric emptying scintigraphy
Institutional review board
Irritable bowel syndrome
Inflammatory bowel disease
Analysis of covariance
Postural orthostatic tachycardia syndrome
Gastroesophageal reflux disease
Proton pump inhibitor
JGC was involved in study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. MR was involved in acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. RL was involved in analysis and interpretation of data; statistical analysis. SG was involved in study concept and design; analysis and interpretation of data; critical revision of the manuscript for important intellectual content; study supervision.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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