Scintigraphy of the Whole Gut: Clinical Evaluation of Transit Disorders

doi:10.4065/70.2.113

Mayo Clinic Proceedings

Volume 70, Issue 2, February 1995, Pages 113-118

https://doi.org/10.4065/70.2.113 Get rights and content

Objective

To describe an initial clinical experience with a nontnvasive scintigraphic technique for assessing gastrointestinal motility.

Design

We studied gastric, small bowel, and colonic transit in 109 undetected patients encountered between June and December 1992 at the Mayo Clinic.

Material and Methods

The study patients were categorized on the basis of major complaint (constipation in 46, upper gastrointestinal symptoms in 45, and diarrhea in 18) and presence or absence of an underlying organic disease. Radioscintigraphy was used to analyze various regions of the gastrointestinal tract; scans were obtained at 2, 4, 6, and 24 hours after ingest ion of a radiolabeled test meal.

Results

Overall, patients with a main complaint of constipation usually had slow or normal gastric, small bowel, and colonic transit, whereas those with diarrhea as the major symptom usually had normal or fast results of these studies. In the 65 patients with no underlying organic disease, inconsistent patterns of gastric emptying and small bowel and colonic transit were noted.

Conclusion

Our results suggest that this 24-hour scintigraphic test may be clinically useful in screening for dysmotility syndromes in patients with nausea, vomiting, diarrhea, or constipation.

Section snippets

MATERIAL AND METHODS

Patients.—Between June and December 1992, colonic transit tests were performed in 109 Mayo Clinic patients; 105 also underwent concurrent measurements of gastric emptying and small bowel transit. All patients had undergone assessment at the Mayo Clinic for gastrointestinal symptoms—constipation in 46, upper gastrointestinal symptoms in 45, and diarrhea in 18 (Table 1).

Organic disease, which was diagnosed or excluded on the basis of investigations appropriate for each patient, was thought to be

RESULTS

Overall Findings.—Gastric emptying and small bowel transit tests were performed in 105 of the 109 study patients, and colonic transit was assessed in 109. Results of gastric emptying were available for 104 of the 105 patients and of small bowel transit for 103 of the 105 because 2 patients vomited the meal after 1 and 3 hours, respectively. All other patients tolerated the procedure well.

The results are summarized in Table 2, stratified by the major complaint. Patients with upper

DISCUSSION

These data describe the results of a simple approach to the measurement of gastric, small bowel, and colonic transit, one that involves the use of gamma scintigraphy for relatively shorter periods than with traditional methods. As a consequence, a less expensive procedure, suitable for routine clinical use, is possible. The methods of preparation are simple and brief. Labeling of the beads and packing of capsules require approximately 15 minutes, and drying of the coated capsule entails a

CONCLUSION

An approach proposed previously6, 7, 10 to develop a relatively inexpensive test for gastric, small bowel, and colonic transit disturbances has been applied to more than 100 unselected patients. This scintigraphic technique could contribute to the rapid, noninvasive, and cost-effective assessment of patients with common gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation.

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: This study was supported in part by Grant DK 32121 from the National Institutes of Health, Public Health Service.

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Scintigraphy of the Whole Gut: Clinical Evaluation of Transit Disorders

Objective

Design

Material and Methods

Results

Conclusion

Section snippets

MATERIAL AND METHODS

RESULTS

DISCUSSION

CONCLUSION

Gastroenterology

Gastroenterology

Gastroenterology

Gastroenterology

Lancet

Gastroduodenal motor function in health and disease

Human gastric emptying and colonic filling of solids characterized by a new method

Am J Physiol