Skip to main content
Gut logoLink to Gut
. 1988 Jan;29(1):85–89. doi: 10.1136/gut.29.1.85

Biphasic nature of gastric emptying.

J A Siegel 1, J L Urbain 1, L P Adler 1, N D Charkes 1, A H Maurer 1, B Krevsky 1, L C Knight 1, R S Fisher 1, L S Malmud 1
PMCID: PMC1433265  PMID: 3343018

Abstract

The existence of a lag phase during the gastric emptying of solid foods is controversial. It has been hypothesised that among other early events, the stomach requires a period of time to process solid food to particles small enough to be handled as a liquid. At present no standardised curve fitting techniques exist for the characterisation and quantification of the lag phase or the emptying rate of solids and liquids. We have evaluated the ability of a modified power exponential function to define the emptying parameters of two different solid meals. Dual labelled meals were administered to 24 normal volunteers. The subjects received meals consisting of either Tc-99m in vivo labelled chicken liver or Tc-99m-egg, which have different densities, and In-111-DTPA in water. The emptying curves were biphasic in nature. For solids, this represented an initial delay in emptying or lag phase followed by an equilibrium emptying phase characterised by a constant rate of emptying. The curves were analysed using a modified power exponential function of the form y(t) = 1-(1-e-kt)beta, where y(t) is the fractional meal retention at time t, k is the gastric emptying rate in min-1, and beta is the extrapolated y-intercept from the terminal portion of the curve. The length of the lag phase and half-emptying time increased with solid food density (31 +/- 8 min and 77.6 +/- 11.2 min for egg and 62 +/- 16 min and 94.1 +/- 14.2 min for chicken liver, respectively). After the lag phase, both solids had similar emptying rates, and these rates were identical to those of the liquids. In vitro experiments indicated that the egg meal disintegrated much more rapidly than the chicken liver under mechanical agitation in gastric juice, lending further support to the hypothesis that the initial lag in emptying of solid food is due to the processing of food into particles small enough to pass the pylorus. We conclude that the modified power exponential model permits characterisation of the biphasic nature of gastric emptying allowing for quantification of the lag phase and the rate of emptying for both solids and liquids.

Full text

PDF
85

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Becker J. M., Kelly K. A. Antral control of canine gastric emptying of solids. Am J Physiol. 1983 Sep;245(3):G334–G338. doi: 10.1152/ajpgi.1983.245.3.G334. [DOI] [PubMed] [Google Scholar]
  2. Camilleri M., Malagelada J. R., Brown M. L., Becker G., Zinsmeister A. R. Relation between antral motility and gastric emptying of solids and liquids in humans. Am J Physiol. 1985 Nov;249(5 Pt 1):G580–G585. doi: 10.1152/ajpgi.1985.249.5.G580. [DOI] [PubMed] [Google Scholar]
  3. Collins P. J., Horowitz M., Chatterton B. E. Attenuation correction and lag period in gastric emptying studies. J Nucl Med. 1986 Jun;27(6):867–868. [PubMed] [Google Scholar]
  4. Collins P. J., Horowitz M., Cook D. J., Harding P. E., Shearman D. J. Gastric emptying in normal subjects--a reproducible technique using a single scintillation camera and computer system. Gut. 1983 Dec;24(12):1117–1125. doi: 10.1136/gut.24.12.1117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Collins P. J., Horowitz M., Shearman D. J., Chatterton B. E. Correction for tissue attenuation in radionuclide gastric emptying studies: a comparison of a lateral image method and a geometric mean method. Br J Radiol. 1984 Aug;57(680):689–695. doi: 10.1259/0007-1285-57-680-689. [DOI] [PubMed] [Google Scholar]
  6. Dugas M. C., Schade R. R., Lhotsky D., Van Thiel D. Comparison of methods for analyzing gastric isotope emptying. Am J Physiol. 1982 Sep;243(3):G237–G242. doi: 10.1152/ajpgi.1982.243.3.G237. [DOI] [PubMed] [Google Scholar]
  7. Elashoff J. D., Reedy T. J., Meyer J. H. Analysis of gastric emptying data. Gastroenterology. 1982 Dec;83(6):1306–1312. [PubMed] [Google Scholar]
  8. Gulsrud P. O., Taylor I. L., Watts H. D., Cohen M. B., Elashoff J., Meyer J. H. How gastric emptying of carbohydrate affects glucose tolerance and symptoms after truncal vagotomy with pyloroplasty. Gastroenterology. 1980 Jun;78(6):1463–1471. [PubMed] [Google Scholar]
  9. Loo F. D., Palmer D. W., Soergel K. H., Kalbfleisch J. H., Wood C. M. Gastric emptying in patients with diabetes mellitus. Gastroenterology. 1984 Mar;86(3):485–494. [PubMed] [Google Scholar]
  10. Malagelada J. R., Go V. L., Summerskill W. H. Different gastric, pancreatic, and biliary responses to solid-liquid or homogenized meals. Dig Dis Sci. 1979 Feb;24(2):101–110. doi: 10.1007/BF01324736. [DOI] [PubMed] [Google Scholar]
  11. Malmud L. S., Fisher R. S., Knight L. C., Rock E. Scintigraphic evaluation of gastric emptying. Semin Nucl Med. 1982 Apr;12(2):116–125. doi: 10.1016/s0001-2998(82)80003-2. [DOI] [PubMed] [Google Scholar]
  12. Meyer J. H., Ohashi H., Jehn D., Thomson J. B. Size of liver particles emptied from the human stomach. Gastroenterology. 1981 Jun;80(6):1489–1496. [PubMed] [Google Scholar]
  13. Meyer J. H., VanDeventer G., Graham L. S., Thomson J., Thomasson D. Error and corrections with scintigraphic measurement of gastric emptying of solid foods. J Nucl Med. 1983 Mar;24(3):197–203. [PubMed] [Google Scholar]
  14. Moore J. G., Christian P. E., Coleman R. E. Gastric emptying of varying meal weight and composition in man. Evaluation by dual liquid- and solid-phase isotopic method. Dig Dis Sci. 1981 Jan;26(1):16–22. doi: 10.1007/BF01307971. [DOI] [PubMed] [Google Scholar]
  15. Moore J. G., Christian P. E., Taylor A. T., Alazraki N. Gastric emptying measurements: delayed and complex emptying patterns without appropriate correction. J Nucl Med. 1985 Oct;26(10):1206–1210. [PubMed] [Google Scholar]
  16. Read N. W., Cammack J., Edwards C., Holgate A. M., Cann P. A., Brown C. Is the transit time of a meal through the small intestine related to the rate at which it leaves the stomach? Gut. 1982 Oct;23(10):824–828. doi: 10.1136/gut.23.10.824. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Siegel J. A. The effect of source size on the buildup factor calculation of absolute volume. J Nucl Med. 1985 Nov;26(11):1319–1322. [PubMed] [Google Scholar]
  18. Siegel J. A., Wu R. K., Maurer A. H. The buildup factor: effect of scatter on absolute volume determination. J Nucl Med. 1985 Apr;26(4):390–394. [PubMed] [Google Scholar]
  19. Smith J. L., Jiang C. L., Hunt J. N. Intrinsic emptying pattern of the human stomach. Am J Physiol. 1984 Jun;246(6 Pt 2):R959–R962. doi: 10.1152/ajpregu.1984.246.6.R959. [DOI] [PubMed] [Google Scholar]
  20. Tothill P., McLoughlin G. P., Heading R. C. Techniques and errors in scintigraphic measurements of gastric emptying. J Nucl Med. 1978 Mar;19(3):256–261. [PubMed] [Google Scholar]
  21. Weiner K., Graham L. S., Reedy T., Elashoff J., Meyer J. H. Simultaneous gastric emptying of two solid foods. Gastroenterology. 1981 Aug;81(2):257–266. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES