Delayed gastric emptying determined using the ¹³C–octanoic acid breath test in patients with systemic sclerosis

Abstract

Objective. To determine the prevalence of delayed gastric emptying using the 13 C-octanoic acid breath test in unselected patients with systemic sclerosis (SSc), to evaluate whether findings of the 13 C-octanoic acid breath test are associated with clinical digestive manifestations, gastric mucosal abnormalities detected by gastroscopy, motor activity dysfunction detected by antroduodenal manometry, and esophageal motor impairment and extradigestive manifestations of SSc, and to develop a risk prediction score of gastric emptying in SSc.Methods. Consecutive patients with SSc (n ‫؍‬ 57) underwent the 13 C-octanoic acid breath test. All of the patients with SSc completed a questionnaire on digestive symptoms, and a global symptom score (GSS) was calculated.Results. The prevalence of delayed gastric emptying was 47.4% in patients with SSc. A marked correlation was observed between a GSS of digestive symptoms >5 and the presence of delayed gastric emptying (P < 0.00001). The sensitivity of a GSS >5 for predicting delayed gastric emptying was as high as 0.93, while the specificity was 0.73. Moreover, a GSS >5, mucosal gastric abnormalities, severe esophageal motor impairment, and interstitial lung disease were factors that were independently associated with the presence of delayed gastric emptying, and these variables were used to create a risk prediction score. The area under the receiver operating characteristic curve for the risk prediction score was 0.90; the sensitivity of this score for the prediction of delayed gastric emptying was 0.93, while the specificity was 0.77. Conclusion.The results indicate that delayed gastric emptying occurs often in patients with SSc. Interestingly, using risk models with routine clinical characteristics, a simple risk prediction score can be calculated, allowing prediction of the occurrence of delayed gastric emptying in patients with SSc.

Small Bowel Capsule Endoscopy

“…Currently, preparation involves fasting, oral cleanser (usually PEG) and avoiding drugs that [26] Parkinson's [459] Connective tissue disorders, e.g. scleroderma [460] Drugs…”

Other Forms of Gastroparesis

“…Furthermore, they described a close correlation between a gastrointestinal symptom score and gastric emptying delay. 103 Other Forms of Gastroparesis Using the same approach, Hammar and colleagues 104 discovered gastroparesis in 29% of their 28 patients with primary Sjö gren syndrome.…”

“…The latter is of critical importance, given the predilection of these patients to severe and complicated reflux resulting from severe lower esophageal sphincter hypotension and markedly impaired esophageal peristaltic amplitude. Using the relatively noninvasive 13 C-octonoic acid breath test, Marie and colleagues 103 documented delayed gastric emptying in 47% of 57 consecutive scleroderma patients. Furthermore, they described a close correlation between a gastrointestinal symptom score and gastric emptying delay.…”

Gastric electrical stimulation increases the discomfort threshold to gastric distension

“…The overall GIQLI score ranges from 0 (worst quality of life possible) to 144 (optimal quality of life). Gastric emptying was evaluated at baseline and then 6 months later, using the 13 C octanoic acid breath test, as detailed in our previous studies [14,15].…”