Gastric Emptying
What does a Gastric Emptying scan do?
uses a radioactive meal that identifies abnormalities related to emptying of the stomach
Radiopharmaceutical used
Sulfer Colloid
3 vials
sodium thiosulfate,gelatin, EDTA
HCL Acid
Sodium Hydroxide
Heating required
0.5-1 mCi Tc-99m Sulfer Colloid
Scrambled eggs
Tasteless
Most Common
Oatmeal
Chicken Liver
Imaging Technique
Continuous data acquisition
30-60 seconds per image
Duration of at least 90 minutes
Images over stomach in the LAO position
Lag phase my appear longer
Alternative
Simultaneous anterior and posterior images
Patient supine
Static images every 10-15 minutes
Simplified 4 hour protocol
simultaneous 1 minute acqusition
acquired at 1,2,4 hours
determine geometric mean
Delayed gastric retention
<34% gastric emptying at 90 minutes
What can affect the scan?
The time of day
More rapid after overnight fast
Male vs Female
Upright positioning/Ambulation
The meal provided
What should the patient do?
Notify doctor if allergic to eggs
Fast for 8 hours
No Tabacco or Alcohol for 24 hours before test
Smoking slows gastric emptying
Discontinue drugs that may interfere with gastric emptying
Narcotic/Opiate analgesics
Prokinetic Agents
Anticholinergics/antispasmodics
Diabetics should have a fasting glucose level <275 mg/dL
After meal is ingested, diabetic pt should administer 1/2 of normal insulin
Symptoms of Delayed Gastric Emptying
Nausea/Vomting
Early Satiety
Post Pradnial Fullness
Abdominal discomfort/bloating
Causes of Delayed Gastric Emptying
Mechanical obstruction should always be excluded
Diabetes Mellitus
Scleroderma
Previous gastric surgery
Idiopathic
Drugs
Nicotine
Calcium Channel Blockers
Levodopa
Therapy for gastroparesis
Drugs
Metoclopramide
Erythromycin
Domperidone
Diabetics
maintain glucose levels <200 mg/dL
Diet
Small frequent meals
Avoid high fiber, high fat meals
Links
Package insert
Practice guidelines
Created by
Amber Spivey
December 2, 2009