Finding an Association between Gastroesophageal Reflux and Delayed Gastric Emptying Using Scintigraphic Method

Background – Scintigraphy remains the gold standard to study gastric emptying. We used this method to demonstrate the impact of delayed gastric emptying on gastroesophageal reflux disease (GERD), one of the most common gastrointestinal disorders. Methods – Scintigraphy was performed for 16 patients with documented GERD and 16 asymptomatic normal volunteers. The test meal was composed of two labeled fried eggs with two slices of bread, and 150 mL of nonlabeled water. Images were obtained in anterior and posterior projections in 30-minute intervals for a total period of two hours. Gastric emptying curves, the estimated time required for the stomach to empty one-half of its original meal (T1/2), and gastric retention activity at 120 minute (RA120) were used for gastric emptying evaluation.Results – Seven (44%) of patients had deviation in their gastric emptying curves compared to normal limits. The mean ± SD of T1/2 and RA120 of the patient group were 95.74 ± 54.00 minutes and 33.03 ± 15.92 percent, respectively; the corresponding figures for the asymptomatic control group were 64.94 ± 14.48 minutes, and 20.31 ± 8.41 percent. There was a significant difference between the means of the two groups (p < 0.05 for T1/2 and p < 0.01 for RA120) using Student t-test. Five (31.25%) patients demonstrated an abnormal T1/2 and the same number revealed an abnormal RA120. Relying upon at least one of these factors, 9 (56.25%) of the patients had evidence of delayed gastric emptying compared to the asymptomatic individuals. Conclusion – We concluded that delayed gastric emptying could be considered as a predisposing factor of GERD. Therefore, we recommend gastric emptying study in all patients suffering from this disease.