Abstract
Using a dual-headed gamma camera and a standardized egg test meal labeled with 99mTc-sulfur colloid, the quantitative emptying of the total, proximal and distal stomach in five normal subjects was characterized. The same egg meal was given to the volunteers in 3 different forms: homogenized, and as 2.5 mm and 5.0 mm cubes on 3 separate occasions for a total of 15 studies. For the total stomach emptying, the lag phase and half emptying time (T 1/2) obtained using a power exponential model were significantly shorter for the homogenized test meal than for the 2.5 mm and 5.0 mm cubed egg particles; the lag phases were 29±19 min (mean±SD) vs 55±56 (P<0.05) and 64±24 min (P<0.01), the T 1/2′s were 71±30 min vs 91±26 (P<0.05) and 104±30 min (P<0.05), respectively. For the proximal stomach, no statistically significant difference was observed among the 3 test meals; the T 1/2s for the homogenized, 2.5 mm and 5.0 mm cubed meals were 65±26 min, 53±18 min and 64±20 min, respectively. For the distal stomach, both the peak activity (%) and time to peak activity (min) were significantly higher for the 2.5 mm cubes (43%, 54 min) and the 5.0 mm cubes (38%, 60 min) than for the homogenized eggs (16.4%, 30 min) (P<0.01). The correlation between the lag phase for the total stomach and the time to peak activity in the distal stomach was excellent (r=0.85, P<0.001 suggesting that the lag phase may correspond to the maximum filling of the distal stomach. These results demonstrate quantitatively that the proximal portion of the stomach is mainly responsible for the receipt and storage of food and the emptying of liquids, while the distal stomach appears to be primarily involved with the processing of solid food before its passage through the pylorus.
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References
Barker MCJ, Cobden I, Axon ATR (1979) Proximal stomach and antrum in stomach emptying. Gut 20:309–311
Becker JM, Kelly KA (1983) Antral control of canine gastric emptying of solids. Am J Physiol 245:G334-G338
Camilleri M, Malagelada JR, Brown ML, Becker G, Zinsmeister AR (1985) Relation between antral motility and gastric emptying of solids and liquids in humans. Am J Physiol 249:G580-G585
Cannon WB (1898) The movements of the stomach studied by means of the Roentgen rays. Am J Physiol 1:359–382
Cannon WB, Lieb CW (1911) The receptive relaxation of the stomach. Am J Physiol 29:267–273
Casarett AP (1968) Radiation biology. Prentice-Hall, New-Jersey, p 142
Cole LG (1931) Radiologio exploration of the mucosa of the gastrointestinal tract. III. Congres Internationale de la Radiologie. Paris, Masson, p 95
Collins PJ, Horowitz M, Cook DJ, Harding PE, Shearman DJC (1983) Gastric emptying in normal subjects-a reproducible technique using a single scintillation camera and computer system. Gut 24:1117–1125
Collins PJ, Horowitz M, Sheaman DJC, Chatterton BE (1984) Correction for tissue attenuation in radionuclide gastric emptying studies: a comparison of a lateral image method and a geometric mean method. Br J Radiol 57:689–695
Collins PJ, Horowitz M, Chatterton BE (1988) Differential emptying rates of proximal and distal stomach in normal subjects. Br J Rad 61:12–18
Gulsrud PO, Taylor IL, Watts HD, Cohen MB, Meyer JH (1980) How gastric emptying of carbohydrate affects glucose tolerance and symptoms after truncal vagotomy with pyloroplasty. Gastroenterology 78:1463–1471
Hamilton SG, Sheiner HJ, Quinlan MF (1976) Continuous monitoring of the effect of pentagastrin on gastric emptying of solid food in man. Gut 17:273–279
Jacobs F, Akkermans LMA, Yoe OH, Hoekstra A, Wittebol P (1982) A radioisotope method to quantify the function of fundus, antrum, and their contractile activity in gastric emptying of a semi-solid and solid meal. In: M Wienbeck (ed) Motility of the digestive tract, Raven Press, New York, pp 233–240
Kelly KA (1980) Gastric emptying of liquids and solids: roles of proximal and distal stomach. Am J Physiol 239:G71-G76
Kelly KA (1981) Motility of the stomach and gastroduodenal junction. In: L.R. Johnson (ed) physiology of the gastrointestinal tract. Raven Press, New York, pp 393–410
Lavigne ME, Wiley ZD, Martin P, Way LW, Sleisenger MH, Mac-Gregor IL (1979) Gastric, pancreatic and biliary secretion, and the rate of gastric emptying after parietal cell vagotomy. Am J Surg 138:644–651
Lawaetz O, Aritas Y, Brown NJG, Ralphs DNL, Sjøntoft E (1982) Distribution of a liquid meal within the stomach and gastric emptying after vagotomy and drainage operations. Gut 23:683–691
Loo FD, Palmer DW, Soergel KH, Kalbfleisch JH, Wood CM (1986) Gastric emptying in patients with diabetes mellitus. Gastroenterology 86:485–494
Malagelada JR, Rees WD, Mazzota LJ, Go VLM (1980) Gastric motor abnormalities in diabetic and postvagotomy gastroparesis: effect of metoclopramide and bethanecol. Gastroenterology 78:286–293
Mayer EA, Thomson JB, Jehn D, Reedy T, Elashoff J, Deveny C, Meyer JH (1984) Gastric emptying of solid food and pancreatic and biliary secretions after solid meals in patients with nonresective ulcer surgery. Gastroenterology 87:1264–1271
Meyer JH, Thompson JB, Cohen MB, Shadchehr A, Mandiolla S (1979) Sieving of food by the canine stomach and sieving after gastric surgery. Gastroenterology 76:804–813
Meyer JH, Ohashi H, Jehn D, Thompson JB (1981) Size of liver particles emptied from the stomach. Gastroenterology 80:1489–1496
Meyer JH, Van Deventer G, Graham LS, Thomson J, Thomasson D (1983) Errors and corrections with scintigraphic measurement of gastric emptying of gastric emptying of solids foods. J Nucl Med 24:197–203
Moore JG, Christian PE, Coleman RE (1981) Gastric emptying of varying meal weight and composition in man. Evaluation by dual liquid and solidphase isotopic method. Dig Dis Sci 26:16–22
Moore JG, Christian PE, Taylor AT, Alazraki N (1985) Gastric emptying measurements: delayed and complex emptying patterns without appropriate correction. J Nucl Med 26:1206–1210
Moore JG, Dubois A, Christian PE, Elgin D, Alazraki N (1986) Evidence for a midgastric transverse band in humans. Gastroenterology 91:540–545
Mroz CT, Kelly KA (1977) The role of the extrinsic antral nerves in the regulation of gastric emptying. Surg Gynecol Obstet 145:369–377
Rees WDW, Go VLW, Malagelada JR (1979) Antroduodenal motor responses to solid-liquid and homogenized meals. Gastroenterology 76:1438–1442
Schindler R (1936) Gastroscopic observation concerned with the gross anatomy of the stomach: The musculus sphincter antri: Observation of the position of the stomach; the mucosal folds. Am J Dig Dis Nutr 3:149–153
Sheiner HJ, Quinlan MF, Thompson IJ (1980) Gastric motility and emptying in normal and post-vagotomy subjects. Gut 21:753–759
Siegel JA, Wu RK, Knight LC, Zelac RE, Stern HS, Malmud LS (1983) Radiation dose estimates for oral agents used in upper gastrointestinal disease. J Nucl Med 24:835–837
Siegel JA (1985) The effect of source size on the buildup factor calculation of absolute volume. J Nucl Med 26:1319–1322
Siegel JA, Urbain JL, Adler LP, Charkes ND, Maurer AH, Krevsky B, Knight LC, Fisher RS, Malmud LS (1988) The biphasic nature of gastric emptying. Gut 29:85–89
Staadas J, Aune S (1970) Intragastric pressure/volume relationship before and after vagotomy. Acta Chir Scand 136:611–615
Stieve H (1918–1919) Der sphincter antri pylori des menschlichen Magens. Anat Anz 15:513–534
Szurszewski JH (1981) Electrical basis for gastrointestinal motility. In: L.R. Johnson (ed) Physiology of the gastrointestinal tract. Raven Press, New York, pp 1435–1466
Tothill P, Mc Loughlin GB, Heading RC (1979) Techniques and errors in scintigraphic measurements of gastric emptying. J Nucl Med 19:256–261
Weiner K, Graham LS, Reedy T, Elashoff J, Meyer JH (1981) Simultaneous gastric emptying of two solid foods. Gastroenterology 81:257–266
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Urbain, JL.C., Siegel, J.A., Charkes, N.D. et al. The two-component stomach: effects of meal particle size on fundal and antral emptying. Eur J Nucl Med 15, 254–259 (1989). https://doi.org/10.1007/BF00257543
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DOI: https://doi.org/10.1007/BF00257543