The first use of nuclear medicine to evaluate gastric motility was performed in 1966 by Dr. Griffith and colleagues of Cardiff, Wales, using a breakfast meal labeled with Chromium-51. By measuring the amount of radioactivity in the stomach (gastric counts) at various time points, they could directly determine the volume of a meal remaining in the stomach and thus determine the rate of gastric emptying (GE). Since then, the modern version of the exam, known as gastric emptying scintigraphy (GES) has become a common diagnostic tool in the assessment of patients with various functional gastrointestinal disorders.
Other tests used to measure GE include breath testing and wireless pH capsules. Breath testing is performed using a standardized meal including Spirulina labeled with Carbon-13. The meal passes through the stomach, into the duodenum where it is absorbed, metabolized in the liver and exhaled by the lungs where it is measured. As transit of the meal through the stomach is the rate-limiting step in the process, the test serves as an indirect measurement of GE, assuming normal bowel, liver, and pulmonary function. The wireless pH capsule test is performed by administering a capsule in conjunction with a nutrient bar. The capsule is monitored by a belt worn by the patient and transit from the stomach to small bowel is detected by a sudden increase in pH, denoting transition from the acidic stomach to the alkaline duodenum.
Given its noninvasive nature and physiologic methodology compared to these other tests, scintigraphy has become the prevailing means by which to measure gastric emptying (GE).
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