Characterization of gastric volume responses and liquid emptying in functional dyspepsia and health by MRI or barostat and simultaneous ¹³C-acetate breath test

Authors: fruehauf, h.¹; steingoetter, a.²; fox, m. r.; kwiatek, m. a.¹; boesiger, p.²; schwizer, w.; fried, m.; thumshirn, m.¹; goetze, o.¹

Source: Neurogastroenterology and Motility, Volume 21, Number 7, July 2009 , pp. 697-e37(-696)

Publisher: Wiley-Blackwell

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Abstract:

The assessment of gastric accommodation and emptying by different methodologies provides inconsistent results. We aimed to compare magnetic resonance imaging (MRI), barostat and ¹³C-acetate breath test (BT) for the assessment of gastric volume responses and emptying in healthy controls (HC) and patients with functional dyspepsia (FD). Eight HC and eight FD patients underwent: (i) continuous BT with simultaneous MRI in the upright position after ingestion of isocaloric, 300 kcal, 200 and 800 mL meals, both labelled with 100 mg of ¹³C-acetate; and (ii) BT with gastric barostat after ingestion of the 200 mL meal. MRI measured total gastric volume and gastric content volume (GCV) at baseline, after filling and during emptying. Meal emptying half-times (T½) for MRI and BT were calculated (mean ± SD). We found: (i) Initial GCV was lower in FD than in HC (762 ± 22 vs 810 ± 52 mL, P < 0.04) after the 800 mL meal but not the 200 mL meal. T½_MRI was shorter for the 800 mL than the 200 mL meal (P < 0.001), but similar in HC and FD (200 mL: HC 117 ± 30 min vs FD 138 ± 42 min, ns; 800 mL: HC 71 ± 16 min vs FD 78 ± 27 min, ns). In contrast, T½_BT was similar between meals and groups (200 mL: HC 111 ± 11 min vs FD 116 ± 19 min; 800 mL: HC 114 ± 14 min vs FD: 113 ± 17 min). (ii) Barostat measurements showed similar postprandial volume increases between groups. We conclude that direct measurements by MRI provide a sensitive, non-invasive assessment of gastric accommodation and emptying after a meal. In contrast to MRI, BT did not detect faster emptying of high-volume compared to low-volume liquid nutrient meals in HC or FD.

Keywords: 13C-sodium acetate breath test; functional dyspepsia; gastric barostat; gastric emptying; gastric volume response; magnetic resonance imaging

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2982.2009.01267.x

Affiliations: 1: Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland 2: Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland

Publication date: 2009-07-01