Clinical characteristics associated with idiopathic rapid gastric emptying in patients referred for gastric emptying studies.

OBJECTIVES Rapid gastric emptying (RGE) is diagnosed with nuclear medicine gastric emptying scintigraphy (GET). The clinical symptoms are non-specific and the pathophysiology in the absence of gastric surgery is poorly understood. Our aim was to evaluate the clinical characteristics associated with idiopathic RGE. METHODS GET studies were reviewed from a database of 1,958 four-hour solid-phase GET performed over an eight-year period. We identified those patients with RGE, defined as 10% retained at four hours), and 1268 (65%) were normal. Idiopathic RGE constituted 23% of all abnormal GET studies. The average age at diagnosis was 54 years and 54% of patients with RGE were female. The majority (69%) of these studies were ordered with an initial clinical suspicion for gastroparesis, versus only 12% with a suspicion for RGE. Among this idiopathic RGE cohort, 71% presented with symptoms of nausea, 43% with vomiting, 32% with abdominal pain, 21% with bloating, and 18% with early satiety; only 8% presented with diarrhea, 0.6% with palpitations, and 0.6% with hypoglycemia. CONCLUSION Idiopathic RGE is an important differential diagnosis in patients presenting with symptoms classically associated with gastroparesis. Few patients had postprandial diarrhea or palpitations as their presenting symptom. Further study of idiopathic RGE syndrome is warranted. This article is protected by copyright. All rights reserved.