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Radionuclide Gastric Emptying Studies in Patients with Anorexia Nervosa

Division of Nuclear Medicine, Department of Radiation Medicine, Department of Psychiatry and Division of Medical Chemistry, University of Kentucky Medical Center, Lexington, Kentucky

Correspondence: For reprints contact: Wei-Jen Shih, MD, Div. of Nuclear Medicine Service, University of Kentucky Medical Center, Lexington, KY 40536.

ABSTRACT

To evaluate gastric emptying in anorexia nervosa patients, 26 patients (17 females, two males, ranging in age from 13 to 40 yr) with upper GI symptoms ingested 150–200 µCi [^99mTc]triethelenetetraamine polysterene resin in cereal and were imaged in the supine position. Data were accumulated at 5 min intervals to obtain the gastric emptying time (GET). The results of the studies were divided into three categories: (a) prolonged, 13 patients; (b) rapid, 11; and (c) normal 3. Twelve of 13 patients with prolonged GET were given 10 mg metoctopramide i.v. injections; nine of the 12 patients had a good response and three had no response. Five of the nine patients underwent metoctopramide therapy and four of the patients showed benefit from the therapy. One patient discontinued metoctopramide therapy because of somnolence. Although all patients had subjective symptoms of gastric dysfunction, our results indicated only 50% had objectively prolonged GET, and another 50% showed normal or even rapid GET. Therefore, this radionuclide study enables (a) quantitatively objective documentation of gastric emptying, (b) separation of those patients with rapid or normal GET from those with prolonged GET, thereby avoiding the possible side effects from metoctopramide medication, and (c) prediction of effectiveness of metoctopramide therapy in patients with prolonged GET.

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