Background/AimsTo report gastric emptying scintigraphy, normal values should be established for a specific protocol. The aim of this study was to provide normal gastric emptying values and determine factors affecting gastric emptying using Asian rice-based meal in healthy volunteers. 372Methods One hundred and ninety-two healthy volunteers were included at 7 tertiary care centers across Thailand. Gastric emptying scintigraphy was acquired in 45 degree left anterior oblique view immediately after ingestion of a 267 kcal steamed-rice with technetium-99m labeled-microwaved egg meal with 100 mL water for up to 4 hours. ResultsOne hundred and eighty-nine volunteers (99 females, age 43 ± 14 years) completed the study. The medians (5-95th percentiles) of lag time, gastric emptying half time (GE T1/2) and percent gastric retentions at 2 and 4 hours for all volunteers were 18.6 (0.

https://clinicaltrials.gov (NCT01878526).

Background: Small intestinal bacterial overgrowth (SIBO) results in nutrient malabsorption and malnutrition, thereby increasing the morbidity and mortality in systemic sclerosis (SSc) patients. Objectives: To evaluate the prevalence and associated factors of SIBO in SSc patients. Method: A cross-sectional study was conducted between July 2015 and January 2016 in SSc patients over 18, using the glucose H 2 /CH 4 breath test to evaluate SIBO. Results: Eighty-nine SSc patients (30 male and 59 female) underwent the glucose H 2 / CH 4 breath test. The mean age was 54.4. Twelve participants were positive for the glucose H 2 /CH 4 breath test, yielding a SIBO prevalence of 13.5% (95% CI 7.2-22.4) among SSc patients. A multivariate analysis revealed that duration of disease >5 years was significantly associated with SIBO (adjusted odds ratio 9.38; 95% CI 1.09-80.47). Conclusion: The prevalence of SIBO, using the glucose H 2 /CH 4 breath test, is not common among Thai SSc patients. However, a positive result was associated with longer duration of disease. K E Y W O R D S hydrogen breath test, scleroderma, small intestinal bacterial overgrowth, systemic sclerosis | CON CLUS IONThe prevalence of SIBO as detected by the glucose H 2 /CH 4 breath test was not common among Thai SSc patients. When present, SIBO was associated with a longer duration of disease. ACK N OWLED G EM ENTSThe authors thank the patients for their participation, the Faculty of Medicine and the Scleroderma Research Group, Khon Kaen University for their support, The Gastroenterological Association of Thailand for its support, and Mr. Bryan Roderick Hamman for assistance with the English-language presentation under the aegis of the Publication

Proton pump inhibitor (PPI) twice daily dosing is a standard therapy for gastroesophageal reflux disease (GeRD) in systemic sclerosis (SSc) but there is no data on its response rate or the predictors of ppipartial response GeRD. Aims were to determine the prevalence of ppi-partial response GeRD in SSc and to define its predictors. A prospective study was conducted in SSc patients with GERD. The patients were treated with omeprazole 20 mg bid for 4 weeks. The severity of symptom-grading by visual analogue scale (VAS) and frequency of symptoms by frequency scale for symptoms of GeRD (fSSG) were assessed at baseline and 4 weeks after treatment. PPI-partial response GERD was defined as less than 50% improvement in the VAS for severity of symptom as well as acid reflux score by FSSG after treatment. According to the sample size calculation, 243 SSc-GERD patients were enrolled; of whom 166 (68.3%) had the diffuse cutaneous SSc. PPI-partial response GERD was found in 131 SSc patients (prevalence 53.9%; 95%CI 47.4-60.3). The multivariate analysis revealed that esophageal dysphagia was an only predictor the PPI-partial response GERD (OR 1.82; 95%CI 1.01-3.29) while neither SSc subset nor severity of skin tightness were significantly associated with PPI-partial response GERD. Half of the SSc patients were ppi-partial response GeRD. esophageal dysphagia was the only predictor of ppi-partial response GeRD in SSc patients. Screening for dysphagia before starting GeRD treatment is helpful for assessment the risk of ppi refractoriness GeRD in SSc patients.

Gastroesophageal reflux disease (GERD) is one of the most prevalent and bothersome functional gastrointestinal disorders worldwide, including in Thailand. After a decade of the first Thailand GERD guideline, physician and gastroenterologist encountered substantially increase of patients with GERD. Many of them are complicated case and refractory to standard treatment. Concurrently, the evolution of clinical characteristics as well as the progression of investigations and treatment have developed and changed tremendously. As a member of Association of Southeast Asian Nations, which are developing countries, we considered that the counterbalance between advancement and sufficient economy is essential in taking care of patients with GERD. We gather physicians from university hospitals, as well as internist and general practitioners who served in rural area, to make a consensus in this updated version of GERD guideline focusing in medical management of GERD. This clinical practice guideline was constructed adhering with standard procedure. We categorized the guideline in to four parts including definition, investigation, treatment, and long-term follow up. We anticipate that this guideline would improve physicians' proficiency and help direct readers to choose investigations and treatments in patients with GERD wisely. Moreover, we wish that this guideline would be applicable in countries with limited resources as well.