At Trinity Medical Imaging we employ the internationally agreed best practice for performing gastric emptying studies. We can confidently say that our studies are reproducible and accurate. We are used to performing studies on children and teenagers, who make up a large number of our patients.
The standard procedure consists of a meal using scrambled eggs labelled with a low dose of a radiopharmaceutical. Unlike other centres, our gastric emptying is measured over four hours to give the most sensitive results.
Gastric emptying studies are the gold standard investigation for the identification of gastroparesis in patients with chronic nausea and vomiting.
During the scan time, patients can enjoy watching a movie or listen to music whilst on the scanner.
By measuring the amount of radioactivity within the stomach during the four hour examination, we can determine whether there is gastroparesis or hypermotility. We are also able to assess for gastro-oesophageal reflux during this study.
The advantage of nuclear medicine over other radiological examinations such as barium fluoroscopy is that we can quantify gastrointestinal transit which leads to a more accurate diagnosis.
In young babies, the study can be modified to use milk or formula feed to measure gastric emptying. We can also investigate for aspiration of gastric contents. This is commonly referred to as a ‘milk aspiration study’.
Gastric emptying study preparation
What is a nuclear medicine gastric emptying study?
A gastric emptying scan (GES) is a nuclear medicine exam that uses a radioactive material that you will eat in a meal. You will eat this meal in the department before your scan. The radioactive material allows us to see how your stomach empties.
This scan is used to help diagnose conditions called motility disorders. These are conditions that change the way the stomach contracts and moves food into your intestines.
Are there are any risks?
As the gamma rays are like X-rays, there are small risks associated with being exposed to radiation. However, the radiation decays away over a few hours and the amount of radiation used in medical imaging is very low. This is comparable to the natural radiation we all receive from the environment over about two months. In fact, the risks from missing a disorder by not having the study may be considerably greater than the risks of the radiation. If you are concerned about the risks of the radiation, please speak to a member of our team.
Is there any special preparation for the scan?
You will need to fast for 6 hours before the scan. If you smoke, do not smoke on the morning of the test and during the hours of the scan.
When you make your appointment, you will be asked what medication you are currently taking, and we may ask you to stop certain medicines before the scan.
Drugs that affect gastric emptying such as metoclopramide, tegaserod, erythromycin, domperidone and antispasmodics are usually stopped for three days prior to the test. Do not take any laxatives on the day before or any time during your study.
What if I am diabetic?
If you have diabetes, skipping breakfast may affect your need for diabetic medication. If you are a diabetic and on insulin, we request that you bring your regular morning dose of insulin with you. You can take this with the meal that will be given to you. You may reduce your insulin dose to adjust for the small size of the breakfast. Often half of your insulin is taken with the test meal. If you take oral hypoglycemic medications, generally these are taken with the meal at Nuclear Medicine. If there are any questions concerning your dose of insulin this should be discussed with your doctor or asking one of our team.
If you are pregnant or breastfeeding
If you are pregnant, or think you may be pregnant, you mustinform the department before attending, and certainly before the radiopharmaceutical is administered.
If you are breastfeeding, please inform the department before attending and you will be advised as to whether you will need to take any precautions. You may be advised to avoid breastfeeding for a few hours afterwards and you may need to express milk before your scan.
Can you bring a relative/friend?
Yes you can, but for reasons of safety, they may not be able to accompany you into the examination room, except in very special circumstances. Please do not bring children with you as they will potentially be exposed to radiation from other patients.
Arriving for your appointment
When you arrive for your appointment, please go to the reception desk, after which you will be shown where to wait until collected by a technologist.
The technologist will explain the procedure, and you can ask any questions. You may be asked some questions about your health, or whether you have had this examination before. You do not need to undress but you should remove any jewellery and metallic objects such as keys, coins or buckles.
What happens during the scan?
You will be taken to the examination room and ask to eat a meal which consists of 2 scrambled eggs together with water. The meal has been labelled with an isotope which will permit pictures to be taken as the meal passes through the stomach and the GI tract. After you have eaten the meal, you will be made comfortable lying down, and the technologist will position the gamma camera over your abdomen. The scan will last one hour, and during this time it is important that you lie still. You can breathe normally during the scan.
After the scan, you will be able to leave the department, but you will need to return for two further images taken of the abdomen at 2 hours and 4 hours after your meal. These will take 15 minutes each.
What if I cannot eat scrambled eggs?
If you are allergic to eggs, then please let us know at the time of booking your appointment, and we will try to provide an alternative meal for you.
How long will it take?
The first scan usually takes one hour and then the two further images take 15 minutes each. You should expect to spend up to four hours with us, but you can leave the department in between your pictures.
Can I listen to music or watch a movie while I have my scan?
Your technologist will ask you whether you would like to listen to music or watch a movie during your scan. You may bring in a CD or DVD, or select music from our selection.
Are there any after-effects?
The radiopharmaceutical causes no side-effects, nor will you feel drowsy. You can drive home afterwards and go about your normal activities.
In addition to mothers who are breastfeeding, parents with young children should notify the technologist, who will explain that it is advisable not to have prolonged close contact with them for the rest of the day. This is to avoid them being exposed to unnecessary radiation.
When will you get the results?
The scan will be examined after your visit and a written report on the findings will be sent to your referring doctor within 7 days.
The radiopharmaceutical required for this examination is ordered especially for you. If you cannot attend your appointment, please let the department know as soon as possible, so that we can use it for someone else.
We hope that this leaflet has answered your questions, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Make sure you are satisfied that you have received enough information about the procedure.