Validated approaches at mayo clinic for measuring gastric and colonic transit of solids and gastric accommodation.

Abstract

Introduction: Advancements in scintigraphic gastrointestinal motility testing that were developed, validated, and replicated in clinical practice at Mayo Clinic have significantly enhanced our understanding and management of gastrointestinal motility disorders. Importantly, normative values in at least 100 healthy controls and estimated inter- and intra-individual coefficient of variation for all parameters have been published for these tests.

Areas covered: This article reviews methodology, accuracy, reproducibility, and diagnostic cutoffs of scintigraphic techniques for measuring gastric emptying, gastric accommodation, and colonic transit, comparing methods from Mayo Clinic with those used elsewhere when appropriate. The review used PubMed and Google Scholar from inception to August 2024, utilizing relevant keywords.

Expert opinion: In our view, scintigraphic testing with high standards of validation, reproducibility, and robust normal control data is required, including the choice of the composition of the meal for gastric emptying of solids. The utility of the distribution of isotope in the proximal and distal stomach as a measurement of accommodation, a vegan meal for gastric emptying measurement, and the use of orally administered radiolabeled liquid to measure colonic transit are promising methods requiring further validation. It is necessary for organizations to develop guidelines on optimizing scintigraphic gut motility measurement.