Gastric emptying of solid food in patients with gastroesophageal reflux

While delayed solid gastric emptying (GE) has been reported in patients with gastroesophageal reflux (GER), the relationship of GE to daytime and/or nighttime reflux patterns, and the severity of endoscopic esophagitis are unknown. The authors measured GE in a study population of symptomatic patients (n=33) with abnormal 24 hour pH monitoring (24 hr pH). The study population was divided into two groups by esophagoscopy; those with (E+=22); and 2) those without (E-=11) erosive esophagitis and/or Barrett's esophagus. GE was measured in all patients and in 15 normal volunteers (NL) by the in vivo labelling of chicken liver with Tc-99m-SC, which was in turn diced into 1 cm. cubes and given in 7 1/2 oz. of beef stew. Upright one minute anterior and posterior digital images were obtained every 15 min. for 2.5 hours. 24 hour pH was divided into daytime (upright) and nighttime (supine) segments, and acid exposure was defined as % time pH < 4 for that posture. There was no correlation between GE T 1/2 and acid exposure, daytime or nighttime, for the patient population as a whole. However, patients with the longest GE T1/2 tended to have severe daytime reflux. The authors rarely found delayed solid food gastric emptying in patients with reflux; moreover, they found no association between GE and either diurnal reflux patterns on 24 hr pH or the severity of endoscopic esophagitis