Liquid gastric emptying time 1/2 in infants: establishing reference range and it's co-relation with presence of gastro-esophageal reflux

Abstract

INTRODUCTIONGastric emptying time ½ (GET ½) is considered as the half time taken for chyme to pass into the duodenum. Gastric emptying depends upon numerous factors, both endogenous and exogenous. Nerve and hormones along with volume of meal, pH, particle size, composition and viscosity play part in gastric emptying.1 In infant population, gastric emptying also depends upon the maturity at the time of birth. The gastric emptying pattern is different in infants fed with breast milk and formula feeds and so gastric emptying has to be diligently worked out. 2There have been many studies performed using different radiopharmaceutical meals such as In-111 micro colloid in fixed quantity of milk, Tc-99m sulfur colloid in dextrose, Tc-99m labeled to chicken liver with establishment of various reference standards for liquid and solid emptying times. These studies have included age group varying from infancy till early childhood and age-related dependence was reported.3-8 The GET ½ or ABSTRACT Background: Gastric emptying time ½ (GET ½) is considered as the half time taken for chyme to pass into the duodenum. Gastric emptying depends upon numerous factors, both endogenous and exogenous. Nerve and hormones along with volume of meal, pH, particle size, composition and viscosity play part in gastric emptying. Aim of the study was to determine liquid gastric emptying Time ½ in infants and to evaluate impact of positive GER on Gastric Emptying Time. Methods: Total 149 full term babies from 29th day to 1 year of age; underwent Tc-99m labeled with Sulfur colloid GER scintigraphy using age specific formula. Babies with gastro-intestinal anomalies, lactose intolerance and low birth weight babies were excluded. The reference range of GET ½ was estimated from GER negative group and the same was compared with GER positive group. Results: Out of 149 babies 96 (64%) babies were GER positive and 53 (36%) were negative for GER. The liquid GET ½ values generated for 29 th day-3 months, 4-6 months, 7-9 months and 10 months -1year were 62.67 (12.42), 69.84 (13), 63.5 (9.7) and 53.2 (10) minutes respectively. The liquid GET½ was found to be delayed in severe GER positive group. Conclusions: The reference range for liquid GET½ was estimated from GER negative group utilizing the exclusion criteria thereby avoiding radiation exposure to normal controls. With increasing severity of GER there was consequent prolongation of liquid GET½.

Perioperative fasting and feeding in adults, obstetric, paediatric and bariatric population: Practice Guidelines from the Indian Society of Anaesthesiologists

“…[ 237 ] Prolongation of liquid gastric emptying half-time was observed with increasing severity of GERD (LOE- Low). [ 238 ] The adult normative data for gastric emptying for solids may be inappropriate for children (5–18 years) (LOE- Low). [ 239 ] In a serial GUS study on stable preterm infants, breast milk composition was found to influence gastric emptying, with feeds of higher casein content emptying faster while fortified mother's milk emptying much slower than unfortified mother's milk (LOE- Low).…”