Does your stomach empty properly after eating? Let's talk about the Gastric Emptying Study!

Have you ever wondered how long the food you eat stays in your stomach and how it gets out of there? Sometimes we feel full or nauseous after eating. At such times, a special test is called a 'Gastric Emptying Study' to see how long the food stays in our stomach and how it gets out. This can help us find out if there is any problem with the functioning of our stomach, that is, the stomach.

What can we really learn from this test?

Imagine, after you eat some food, do you feel things like this:

• I feel full for a while , and that fullness has been there for a long time .
• I often feel nauseous and vomit .
• I have pain in the upper abdomen.
• My stomach feels full, like it's bloated .
• I lose my appetite and lose weight .
• Blood sugar levels suddenly go up and then down again .
• It feels like dizziness .
• It feels like your heart is suddenly beating faster .
• There are conditions like indigestion and gastritis .
• Constantly coming up into the throat (chronic acid reflux) .

If you have these symptoms, your doctor may suggest a gastric emptying study. Simply put, this test measures whether food is moving out of your stomach too slowly or too quickly . It can also give you an idea of ​​where in your stomach this speed is slowing down and which parts of your stomach are affected. This can help you understand the cause of some of your gastrointestinal (GI) symptoms.

What kind of diseases does this detect?

Now let's see what diseases this test can detect.

• If your stomach is emptying slowly: This could be a sign that there is an obstruction in your stomach. Or, it could be a condition called gastroparesis, which is a condition where the muscles and nerves in your stomach are not working properly, causing your stomach to become paralyzed . Gastroparesis is a problem with the muscles and nerves in your stomach.
• If your stomach empties too quickly: This is called dumping syndrome . This is also related to the muscles and nerves in your stomach. This condition is usually seen after stomach surgery. However, if you haven't had surgery, it could be a sign of another underlying condition.

How is the most commonly performed Gastric Emptying Scintigraphy test performed?

The main method of doing this Gastric Emptying Study is called Gastric Emptying Scintigraphy (GES) . This is the name most doctors use. This is actually a nuclear medicine imaging test . Simply put, it uses radiation to scan your body and create images.

Think of it like an 'inside-out X-ray'. A normal X-ray sends radiation through your body from the outside. But in this case, a special radioactive tracer is added to the food you eat. When this tracer enters, it emits gamma rays . Then, a gamma camera detects this radiation and converts it into a two-dimensional image. This is how you see the food you eat moving through your stomach.

Before this test, you will be given a standard diet that is the same for everyone. It contains certain amounts of fiber, sugar, protein, and fat. This is because all of these things affect the movement of the stomach, that is, gastric motility . The radioactive isotope that is added to this food is called Sulfur Colloid (99mTc) . This has very little harm to the body, which means the risk of toxicity is very low .

Are there any other methods besides this one?

Yes, there are several other ways to check stomach function.

• Gastric Motility Breath Test (GEBT): This involves testing your breath. A special food you drink contains a carbon molecule called Carbon-13 . When this goes into your intestines, a special type of measurable carbon dioxide (CO2-13) gas is produced. That gas is measured in your breath to see how fast the food is moving.
• SmartPill™ Wireless Motility Capsule: This involves swallowing a small, pill-like electronic device . As it travels through your digestive system, it wirelessly transmits information to a receiver you wear. The SmartPill™ is passed out in your stool in a day or two. Then, when you give the receiver to your doctor, they can analyze the data and make a diagnosis.

What should we be aware of before the test?

Before you have this test, your doctor will talk to you about it. They will ask about any other medical conditions you have and any medications you are taking, as these can affect the test results.

• ( - Hyperglycemia) ( - Hypoglycemia), maybe this test doesn't suit you.
• It is best to avoid this test if you are pregnant or breastfeeding . The reason for this is the radioactive material.
• If you have a menstrual cycle , your doctor may want you to take this test on a specific day of your menstrual cycle, as hormonal changes can affect the rate at which your stomach empties, which can alter the results.

How to prepare for the test?

Your stomach needs to be empty when you have this test. So your doctor will tell you not to eat or drink anything for at least four hours before the test. Most often, this test is done in the morning, so it's easier for you to not eat or drink anything the night before.

• If you have diabetes and use insulin , you will be asked to bring your insulin and a glucose monitor . Before the test, they will check your blood sugar level, record it, and give you insulin if necessary to bring it back to the right level.
• It is not a good idea to smoke before the test, as this can delay the emptying of the stomach.
• You may also be asked to stop taking certain medications a few days before the test. For example:
• Blood thinners
• Some painkillers, especially opioids
• Some antidepressants
• Calcium channel blockers
• Acid-blocking medications
• Feminizing hormone therapy

Remember, this list is not complete, so it is very important to tell your doctor about all the medications you are taking.

What happens during the test?

Okay, now let's see what happens when we do the test.

• First, you will be given the special meal I mentioned earlier. It consists of a fried egg white mixed with a sulfur colloid , a slice of bread with strawberry jam, and a glass of water. It is very important to finish all of this within ten minutes .
• If possible, you will need to stand up while the test is performed. If not, you may lie down. The technician will then position the camera or cameras on your abdomen.
• The scanner scans your stomach continuously for about a minute . It scans about four or five times like this.
• The first scan is done right after you finish eating . If the technician suspects that your stomach is emptying too quickly, he or she will do another scan after 30 minutes . The other scans are doneAfter an hour, two hours and four hours.
• You can get up and leave the room during this scan, but you must come back on time.

How long does this test take?

Gastric Emptying Scintigraphy usually takes about two to four hours to complete. Two hours is the average time it takes for a stomach to empty. So if your stomach is completely empty within that time, they will stop scanning at that point. But if it takes longer than that, they can scan for up to four hours.

Is this painful? Does it feel uncomfortable?

Not at all. You won't feel the scan or the radioactive material at all . You can't detect the substance in the food by taste or smell. So don't worry about any discomfort.

What is a Gastric Emptying Liquid Study?

Sometimes doctors will order a separate test for liquids (a liquid emptying study) . This can provide additional information about your condition. Because liquids do not move through the stomach the same way solid food does, the results of this test may be different. Your doctor may order this liquid test at the same time as the solid food test. Or, they may order this test at a later date after the solid food test.

This is a short test . You'll be given a cup of water with sulfur colloid in it. Then the technician will take about three sets of images over the course of an hour.

Are there any risks or side effects of the Gastric Emptying Scintigraphy test?

The amount of radiation that is put into your body is very small , and it is not enough to harm you. However, if you are pregnant, there may be a small risk to your unborn baby . If you are a breastfeeding mother, a small amount of radiation can pass to your baby through your milk . That is why the test is postponed. Otherwise, there are no other known side effects .

This radioactive material will be almost completely eliminated from your body in your urine and stools in about two days. Drink plenty of water during those days, as this will help it leave your body more quickly.

How do I understand my test results?

Your doctor will review the test results and explain them to you. The results show how long it took for the food you ate to move through your stomach. They will show how far it went in one hour, two hours, or four hours. They will then compare the results with the average. If your results are faster or slower than normal, it means that your stomach is emptying too quickly or too slowly.

What should normal results be like?

For solid foods:

• In 30 minutes:At least 70% of the food should still be in the stomach.
• In an hour: At least 30% of the food should still be in the stomach, and at least 10% should be empty.
• In two hours: At least 40% of the food should be empty.
• In four hours: At least 90% of the food should be empty.

The average time for a liquid test is between 20 and 25 minutes .

What are abnormal results?

You may have gastroparesis if:

• If more than 60% of the food is still in the stomach after two hours.
• If more than 10% of the food is still in the stomach after four hours.

You may have Dumping Syndrome , a condition in which the stomach empties too quickly, if:

• If more than 30% of the food is already empty after 30 minutes.
• If more than 70% of the food is already empty after an hour.

Finally, things you need to remember

Gastric Emptying Scintigraphy is a simple, noninvasive, and accurate way to check your stomach's function, or gastric motility .

It can reveal a lot about how your gut is working, without any hassle, and in just a few hours of your time. Perhaps you have had symptoms for a long time that you could not find a cause for, and the cause of the symptoms that did not improve with treatment may now be clear. These test results will be a great help to your doctor in diagnosing your exact condition. Therefore, if a doctor suggests this test, there is nothing to be afraid of. Talk to your doctor about it thoroughly, understand everything, and undergo the test.

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