Rapid Gastric Emptying: An Alternative and Frequent Form of Gastric Dysmotility

Introduction: Rapid gastric emptying is a clinical phenomenon that has not been emphasized in the published literature. In this study, we aim to identify the prevalence of rapid gastric emptying amongst patients suspected of having gastroparesis and the role of symptoms in this form of gastric dysmotility. Methods: We studied 309 patients with symptoms suggestive of gastroparesis who underwent gastric emptying study between January 2013 and June 2014. We recorded the retention rates at hours 2 and 4, symptoms of nausea and vomiting, bloating, postprandial abdominal pain, and early satiety. We defined rapid gastric emptying as < 16% retention at two hours based on the first quartile value in asymptomatic patients described in a previous study. Patients with prokinetic use within 48 hours prior to gastric emptying study were excluded. SAS v9.3 software was used for statistical analysis. Results: Among 309 patients, 89 patients (28.8%) met the criteria for rapid emptying. Predominant symptoms were nausea and vomiting (53.9%) and bloating (50.6%), while 18% reported symptoms of early satiety and 4.5% reported postprandial abdominal pain. Thirty-six patients with rapid gastric emptying carried a diagnosis of diabetes mellitus. Bloating was more prevalent in patients with rapid emptying compared to the others (50.6% versus 31.8%, P 0.002). No statistically significant differences were noted in nausea and vomiting (p 0.079), postprandial abdominal pain (p 0.17), early satiety (p 0.97), or frequency of diabetes (p 0.11) between the two groups. Conclusion: 1) Rapid gastric emptying is often found in patients with symptoms thought to be caused by gastroparesis. 2) Nausea, vomiting, and bloating were the predominant symptoms in patients with rapid gastric emptying. Bloating was significantly more common in patients with rapid gastric emptying compared to the rest of our cohort. 3) Distinguishing rapid from delayed gastric emptying may be essential to direct treatment in these patients. 4) Large, prospective trials are warranted to further explore this phenomenon.