Scintigraphic methods to evaluate alterations of gastric and esophageal functions in female obesity

Mol Imaging Radionucl Ther. 2014 Feb;23(1):5-11. doi: 10.4274/Mirt.14633. Epub 2014 Feb 5.

Abstract

Objective: Altered gastrointestinal function has frequently been observed in obese patients. The aim of this study was to investigate the frequency of gastro-esophageal reflux (GER) and to determine the alterations of gastric emptying and esophageal transit by scintigraphic methods in obese patients.

Methods: Scintigraphic studies of 50 obese female non-diabetic patients who had not received any treatment for weight control were retrospectively reviewed. Mean Body Mass Index (BMI) was 34.96±3.04 kg/m(2) (range:32-39 kg/m(2)). All subjects were submitted to scintigraphic evaluation of esophageal transit, gastro-esophageal reflux, gastric emptying and presence of Helicobacter pylori infection. The data of obese patients were compared with those of sex-age matched 30 non-obese cases who were selected from our clinical archive.

Results: In obese group, seventeen (34%) patients were found to be GER positive scintigraphically; mean gastric emptying time (t½) was 59.18±30.8 min and the mean esophageal transit time was 8.9±7.2 s. Frequency of positive GER scintigraphy and the mean value of esophageal transit time were significantly higher in obese patients than non-obese control subjects. Gastric emptying time and esophageal transit time values were significantly longer in GER positive obese patients than GER negative ones. There was no statistically significant difference in the frequency of positive C14 urea breath test between obese and non-obese subjects and there were also no statistically significant correlations between BMI, GER, esophageal transit time and gastric emptying time.

Conclusion: In our study, 42 of the 50 obese patients had esophago-gastric motility alterations. The significance of these alterations in obesity is not fully understood, but it is believed that these changes could be because of potential contributing factors in the development or maintenance of obesity or changes in eating habits.

Conflict of interest: None declared.

Amaç: Obezitede gastrointestinal fonksiyon değişiklikleri sıklıkla meydana gelmektedir. Bu çalışmada obez olgularda gastroözefageal reflü (GÖR) sıklığını araştırmak, mide boşalım ve özefagus transit zamanlarındaki değişiklikleri sintigrafik yöntemlerle değerlendirmek amaçlandı.Yöntem: Kilo kontrolüne yönelik tedavi almayan, diyabetik olmayan 50 kadın obez olguya ait veriler retrospektif olarak incelendi. Ortalama Vücut Kitle İndeksi (BMI) 34.96±3.04 kg/m2 idi (değer aralığı: 32-39 kg/m2). Tüm olgularda özefagus transit ve mide boşalım zamanları, gastroözefageal reflü varlığı sintigrafik yöntemlerle değerlendirildi. Elde edilen veriler klinik arşivimizde bulunan yaşları uyumlu obez olmayan 30 kadın olguya ait sonuçlar ile karşılaştırıldı.Bulgular: Obez grupta 17 olguda (34%) sintigrafik olarak gastroözefageal reflü saptandı. Ortalama mide boşalım yarı zamanı (t½) 59,18±30,8 dk, ortalama özefagus transit zamanı ise 8,9±7,2 saniye idi. GÖR sıklığı ve ortalama özefagus transit zamanı obez grupta kontrol grubuna gore anlamlı yüksek bulundu. Mide boşalım ve özefagus transit zamanları GÖR saptanan obez olgularda, GÖR saptanmayanlardan anlamlı yüksekti. Obez ve obez olmayan olgular arasında C14 üre nefes testi pozitifliği açısından anlamlı fark bulunmadı. Vücut kitle indeksi ile GÖR, özefagus transit ve mide boşalım zamanları arasında anlamlı korelasyon saptanmadı.

Keywords: esophageal motility disorders; gastroesophageal reflux; obesity.