Gastric Emptying Study Procedures

Gastric Emptying Study: Procedures and Patient Preparation

• Disruption to Gastric Emptying: Diseases or surgeries can disrupt the normal rate of gastric emptying, causing symptoms such as nausea, vomiting, weight loss, and abdominal discomfort.

Patient Preparation

• Fasting Requirements: Patients must fast for at least 4 hours before the study, ideally starting at midnight.
• Pre-Study Information: Inform patients about the meal, eating time (less than 10 minutes), imaging duration, number of images, and allowed activities between images.
• Diabetic Patient Considerations: Patients with diabetes should bring glucose monitors and insulin. Maintain good blood sugar control, ideally below 200 mg/dL. Monitor glucose levels and adjust morning insulin doses for the meal.
• Female Patient Considerations (Premenopausal): Avoid testing during days 1-10 of the menstrual cycle to minimize hormonal effects on gastrointestinal motility.
• Medication Considerations: Stop prokinetic agents (metoclopramide, tegaserod, domperidone, erythromycin), and medications that delay gastric emptying (opiates, antispasmodic agents) 2 days before the test. Other medications affecting gastric emptying, such as atropine, nifedipine, progesterone, and octreotide, should also be considered.

Standard Meal Composition

• Meal Components: The meal consists of 118 mL liquid egg whites, 2 slices toasted white bread, 30 g jam/jelly, and 120 mL water.
• Preparation Instructions: Mix 0.5-1 mCi of Tc-99m sulfur colloid into the liquid egg whites, cook until firm, toast the bread, and spread with jelly. Eat as a sandwich or separately.

Imaging Procedure

• Positioning: Patients are positioned supine under a scintillation camera.
• Initial Imaging: Obtain anterior and posterior planar images, or a single left anterior oblique image immediately after meal ingestion, for 1 minute.
• Subsequent Imaging: Obtain repeated images in the same projection at hourly intervals for up to 4 hours.
• Static Imaging: Acquire static images every 15 minutes to calculate gastric emptying retention and emptying time.
• Dynamic Imaging: Essential for calculating the emptying halftime from the time-activity curve.
• Image Diagnosticity: Static images alone are not considered indicative of the diagnostic outcome.

This quiz covers the essential procedures and patient preparation for a gastric emptying study. It includes fasting requirements, special considerations for diabetic and female patients, and important pre-study information that must be communicated to patients. Test your knowledge on ensuring optimal preparation for this critical diagnostic procedure.