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Duration of Gastric Emptying - An Overview

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The movement of the stomach's contents into the duodenum is called gastric emptying. Read below to learn more.

Medically reviewed by

Dr. Kaushal Bhavsar

Published At April 21, 2023
Reviewed AtJune 13, 2023

Introduction

The process of digestion plays a major role in the absorption of essential nutrients by breaking down the food that is consumed. The digestive system contains both hollow organs (mouth, esophagus, stomach, duodenum, small and large intestines, and anus) and solid organs (liver, pancreas, and gallbladder). The nutrients are absorbed by the small intestine from the chyme and transferred to the bloodstream, and the wastes are sent to the large intestine. The factors that help in digestion are nerves, blood, hormones, gastric juices, enzymes, and gut flora. The mechanical support for digestion comes from the muscles of the digestive system, which mash and push the food down along the digestive tract; this alternate contraction and relaxation of the digestive tract is known as peristalsis. Peristalsis is an involuntary movement that helps in the movement and mixing of food with gastric juices and digestive enzymes.

What Is Gastric Emptying?

Gastric emptying is the transfer of chyme (completely digested food ready for absorption) from the stomach to the duodenum (the first part of the small intestine) for absorption. The three mechanisms involved in gastric emptying are:

  • Peristalsis.

  • Antral contractions (antrum is the portion before the beginning of duodenum).

  • Shrinkage of stomach.

The factors that help in achieving balanced gastric emptying are:

  • Metabolic load.

  • Neural regulations.

  • Hormones.

Is There Any Difference in the Time Taken for Digestion and Gastric Emptying?

Men and women digest food at different rates and in different time frames. It takes food between six and eight hours for the chyme to cross the small intestine after absorption from the time of consumption. The remainder of the food is then digested in the large intestine, where water is also absorbed and undigested food is ultimately eliminated. Food passes completely through the colon in around 36 hours. Overall, depending on the person, the entire process of digestion, from the time of swallowing the food to the time it leaves the body as feces, takes approximately two to five days.

The time taken for gastric emptying is around one and a half to two hours after swallowing. When the duration of gastric emptying increases, it is called gastroparesis, when it decreases, it is called dumping syndrome or rapid gastric emptying.

What Do Tests for Stomach Emptying Entail?

Gastric emptying tests track how long it takes for food to leave the stomach. This test is advised for patients with abdominal pain, bloating, nausea, vomiting, loss of appetite, feeling full, and sudden weight loss. The gastric emptying tests available are:

1. Gastric Emptying Scintigraphy: The patient is asked to eat a small amount of food along with the radioactive substance caller tracer. The movement of food is observed through a scanner by imaging the tracer. The images will be captured in intervals of one, two, and four hours after the capture of the first image.

  • One hour: less than 50 percent - Normal liquid retention.

  • Normal solid retention.

  • Two hours: less than 60 percent.

  • Four hours: zero to ten percent - Greatest specificity in the diagnosis of delayed gastric emptying.

  • Rapid gastric transit of solids in less than 70 percent at 30 min or less than 30 percent at 60 min less than 50 percent retention at one hour.

2. Barium Swallow: Once the patient swallows the barium drink, they lie flat on an X-ray table flat. The real-time image of the barium movement is captured using the fluoroscopy technique, this imaging will be done in different positions at different intervals.

3. Gastric Emptying Breath Test: The patient is asked to eat a type of protein that releases a substance in the breath. The breath samples are collected at different time intervals. Until the complete sample collection is done the patient is asked to stay without smoking and eating. The collected breath samples are analyzed for gastric emptying time.

4. Wireless Motility Capsule: The patient swallows a smart pill (tiny electronic device) and wears a receiver around their waist. The smart pill collects the data and transmits them to the receiver The smart pill will be excreted through normal bowel movements and the patient might not notice its exit. The radiologists study the information in the receiver to assess gastric emptying.

What Is Gastroparesis?

Gastroparesis, or delayed gastric emptying, is the increase in time taken for food to move from the stomach to the small intestine, which can cause malnutrition. Food can solidify into a solid mass known as a bezoar if it stays in the stomach for an extended period of time. A bezoar may result in a potentially harmful obstruction that stops food from entering your small intestine.

  • Symptoms:

  1. Feeling full before or after finishing a meal.

  2. Feeling full for a long time after finishing a meal.

  3. Feeling nauseated or vomiting.

  4. The most typically recognized cause of gastroparesis is diabetes.

  • Treatment: Based on the cause, the severity of symptoms, and the patient, the treatment is given. If the patient is noted to have uncontrolled blood sugar levels, it must be managed as a priority. Eating habits can lessen gastroparesis symptoms. If the patient is underweight or dehydrated because of gastroparesis, diet helps ensure that you get the correct number of calories, nutrients, and liquids.

What Is Dumping Syndrome?

Food, especially food heavy in sugar, that can pass from the stomach into the small intestine too quickly is called dumping syndrome. The majority of dumping syndrome sufferers have symptoms ten to 30 minutes after eating. Some individuals have symptoms one to three hours after eating. Some patients exhibit both early and late signs.

  • Symptoms:

  1. Early symptoms are bloating, nausea, vomiting, abdominal cramps, diarrhea, flushing, dizziness, and rapid heart rate.

  2. Late symptoms include sweating, flushing, dizziness, lightheadedness, weakness, and rapid heart rate.

  3. Any abdominal surgery causes abnormally quick gastric emptying.

  • Treatment: Subcutaneous injections of anti-diarrheal drugs are given to slow down gastric emptying. The complications of these injections are nausea, diarrhea, and steatorrhea (greasy stools). If the patient does not respond to anti-diarrheal drugs, either a pylorus reconstruction surgery or surgery to undo a gastric bypass surgery is advised.

Conclusion

Digestion breaks down food particles and helps in the absorption of nutrients. Digestion takes place progressively at different levels of the digestive system. From the time of swallowing food to the excretion of feces, the process happens for around three to five days. The signs and symptoms of an increased or decreased gastric emptying period are similar. Early diagnosis and management can help in the prevention of highly complicated abdominal surgeries.

Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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