Gastric accommodation and emptying in evaluation of patients with upper gastrointestinal symptoms
Open accessAbstract
Background & aims Endoscopy-negative dyspepsia is a common symptom that often is difficult to define in pathophysiologic terms. The aim of this study was to assess the frequency of disordered gastric accommodation and emptying in patients referred with unexplained upper gastrointestinal symptoms.Methods A computerized diagnostic index was used to identify all patients, 18-70 years old, who underwent single-photon emission computed tomography (SPECT) to assess gastric accommodation at Mayo Clinic Rochester over a 3-year period. Demographics, clinical features, and results of diagnostic testing, including scintigraphic gastric emptying, were extracted from the electronic record.Results A total of 214 patients were identified; the primary clinical diagnoses were functional dyspepsia, postfundoplication syndromes, rumination syndrome, and diabetic dyspepsia. Gastric accommodation was impaired in 43% of the whole group: 47% of functional dyspepsia, 44% of postfundoplication syndromes, and 33% of diabetic dyspepsia. Delayed gastric emptying was most prevalent in diabetic dyspepsia, and was accelerated in postfundoplication syndromes groups. Thirty-seven percent of patients had abnormal gastric emptying. The highest prevalence of delayed gastric emptying was in the diabetic dyspepsia and accelerated gastric emptying in postfundoplication syndromes groups. Twenty-five percent of patients with normal gastric emptying had impaired accommodation. Upper-gastrointestinal symptoms were not different in groups based on gastric accommodation or emptying results.Conclusions Impaired gastric accommodation is common in patients with unexplained dyspepsia. Symptoms alone cannot predict physiologic disturbances. These noninvasive tests identify single or combined pathophysiologic disturbances and may help to identify subgroups of patients as candidates for more selective pharmacotherapy in the future.
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Altered GI motility and transit have long been recognized in the pathobiology of FGIDs such as IBS and functional dyspepsia.
“Altered GI motility and transit have long been recognized in the pathobiology of FGIDs such as IBS48 and functional dyspepsia (FD)49, 50.”
From The gut Microbiome in adult and pediatric functional gastrointestinal disorders (2019) · cites this paper as [50]
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Browning, K. N., & Travagli, R. A. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01592.x · Cited by 88 · see citing works
Antispasmodic Potential of Medicinal Plants: A Comprehensive Review
Rauf, A., Akram, M., Semwal, P., Mujawah, A., Muhammad, N., Riaz, Z., Munir, N., Piotrovsky, D., Vdovina, I. V., Bouyahya, A., et al. (2021) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2021/4889719 · Cited by 84 · see citing works
Relationship Between Control of Glycemia and Gastric Emptying Disturbances in Diabetes Mellitus
Halland, M., & Bharucha, A. E. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.11.021 · Cited by 84 · see citing works
Ford, A., Thabane, M., Collins, S., Moayyedi, P., Garg, A., Clark, W., & Marshall, J. (2010) · Gastroenterology · doi:10.1053/j.gastro.2010.01.043 · Cited by 79 · see citing works
Pathophysiology as a basis for understanding symptom complexes and therapeutic targets
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Self-citationFunctional Dyspepsia and Gastroparesis
Camilleri, M. (2016) · Digestive Diseases · doi:10.1159/000445226 · Cited by 77 · see citing works
Self-citationApplication of magnetic resonance imaging to measure fasting and postprandial volumes in humans
Fidler, J. L., Bharucha, A. E., Camilleri, M., Camp, J. J., Burton, D. B., Grimm, R., Riederer, S. J., Robb, R. A., & ZINSMEISTER, A. R. (2008) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2008.01194.x · Cited by 75 · see citing works
Self-citationDiagnostic Assessment of Diabetic Gastroparesis
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Self-citationTests of Gastric Neuromuscular Function
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Saito, Y., Suzuki, H., Tsugawa, H., Suzuki, S., Matsuzaki, J., Hirata, K., & Hibi∥, T. (2010) · Gastroenterology · doi:10.1053/j.gastro.2010.08.044 · Cited by 66 · see citing works
Rapid Gastric Emptying Is More Common than Gastroparesis in Patients With Autonomic Dysfunction
Lawal, A., Barboi, A., Krasnow, A., Hellman, R., Jaradeh, S., & Massey, B. T. (2007) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00946.x · Cited by 66 · see citing works
Jeong, I. D., Camilleri, M., Shin, A., Iturrino, J., Boldingh, A., Busciglio, I. A., Burton, D. D., Ryks, M. D., Rhoten, D. L., & Zinsmeister, A. R. (2012) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2012.05040.x · Cited by 65 · see citing works
Self-citationRecent insights into digestive motility in functional dyspepsia
Mizuta, Y., Shikuwa, S., Isomoto, H., Mishima, R., Akazawa, Y., Masuda, J.-I., Omagari, K., Takeshima, F., & Kohno, S. (2006) · Journal of Gastroenterology · doi:10.1007/s00535-006-1966-z · Cited by 64 · see citing works
Chedid, V., Brandler, J., Vijayvargiya, P., Park, S.-Y., Szarka, L. A., & Camilleri, M. (2019) · American Journal of Gastroenterology · doi:10.1038/s41395-018-0234-1 · Cited by 65 · see citing works
Self-citationDelgado-Aros, S., Camilleri, M., Castillo, E. J., Cremonini, F., Stephens, D. A., Ferber, I., Baxter, K. L., Burton, D. D., & Zinsmeister, A. R. (2005) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(05)00285-5 · Cited by 63 · see citing works
Self-citationVella, A. V., Bock, G., Giesler, P. D., Burton, D. B., Serra, D. B., Ligueros‐Saylan, M., Deacon, C. F., Foley, J. E., Rizza, R. A., & Camilleri, M. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03235.x · Cited by 62 · see citing works
Self-citationGastrointestinal Motility, Part 1: Esophageal Transit and Gastric Emptying
Maurer, A. (2015) · Journal of Nuclear Medicine · doi:10.2967/jnumed.112.114314 · Cited by 54 · see citing works
Measurement of Gastrointestinal and Colonic Motor Functions in Humans and Animals
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Self-citationBouras, E. P., Talley, N. J., Camilleri, M., Burton, D. D., Heckman, M. G., Crook, J. E., & Richelson, E. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.02021.x · Cited by 60 · see citing works
Self-citationBreen, M. A., Camilleri, M., Burton, D. D., & Zinsmeister, A. R. (2011) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01660.x · Cited by 58 · see citing works
Self-citationWauters, L. I., Dickman, R. M., Drug, V. L., Mulak, A., Serra, J., Enck, P., Tack, J. F., ESNM FD Consensus Group, Accarino, A. M., Barbara, G., et al. (2021) · Neurogastroenterology & Motility · doi:10.1111/nmo.14238 · Cited by 58 · see citing works
Delgado-Aros, S., & Camilleri, M. (2005) · Journal of Clinical Gastroenterology · doi:10.1097/01.mcg.0000156114.22598.1b · Cited by 57 · see citing works
Self-citationVagal afferent fibres determine the oxytocin‐induced modulation of gastric tone
Holmes, G. M., Browning, K. N., Babic, T., Fortna, S. R., Coleman, F. H., & Travagli, R. A. (2013) · The Journal of Physiology · doi:10.1113/jphysiol.2013.253732 · Cited by 56 · see citing works
Kolar, G. J., Camilleri, M., Burton, D. D., Nadeau, A. M., & Zinsmeister, A. R. (2013) · Neurogastroenterology & Motility · doi:10.1111/nmo.12242 · Cited by 56 · see citing works
Self-citationHalawi, H., Camilleri, M., Acosta, A. J., Vázquez‐Roque, M. I., Oduyebo, I., Burton, D. D., Busciglio, I. A., & Zinsmeister, A. R. (2017) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00190.2017 · Cited by 56 · see citing works
Self-citationAGA Clinical Practice Guideline on Management of Gastroparesis
Staller, K. D., Parkman, H. P., Greer, K. B., Leiman, D. A., Zhou, M. J., Singh, S., Camilleri, M., & Altayar, O. (2025) · Gastroenterology · doi:10.1053/j.gastro.2025.08.004 · Cited by 61 · see citing works
Self-citationJacob, D. A., Busciglio, I., Burton, D., Halawi, H., Oduyebo, I., Rhoten, D., Ryks, M., Harmsen, W., & Camilleri, M. (2017) · American Journal of Physiology - Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00197.2017 · Cited by 44 · see citing works
Self-citationVijayvargiya, P., Iturrino, J., Camilleri, M., Shin, A., Vázquez‐Roque, M. I., Katzka, D. A., Snuggerud, J. R., & Seime, R. J. (2014) · United European Gastroenterology Journal · doi:10.1177/2050640613518774 · Cited by 54 · see citing works
Self-citationTominaga, K., & Arakawa, T. (2013) · Journal of Gastroenterology · doi:10.1007/s00535-013-0788-z · Cited by 54 · see citing works
Aerophagia in adults: a comparison with functional dyspepsia
Chitkara, D. K., Bredenoord, A. J., Rucker, M. J., & Talley, N. J. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02651.x · Cited by 54 · see citing works
Self-citationKindt, S., Coulie, B. J., Wajs, E., Janssens, J., & Tack, J. F. (2008) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2008.01092.x · Cited by 53 · see citing works
Gonenne, J., Castillo, E. J., Camilleri, M., Burton, D. D., Thomforde, G. M., Baxter, K. L., & Zinsmeister, A. R. (2004) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2004.00588.x · Cited by 53 · see citing works
Self-citationEusebi, L., Ratnakumaran, R., Bazzoli, F., & Ford, A. (2018) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2017.07.041 · Cited by 44 · see citing works
Gastric motor disturbances in patients with idiopathic rapid gastric emptying
Bharucha, A. E., Manduca, A., Lake, D. S., Fidler, J. L., Edwards, P. K., Grimm, R. C., Zinsmeister, A. R., & Riederer, S. J. (2011) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2011.01710.x · Cited by 50 · see citing works
Mimidis, K., & Tack, J. F. (2008) · Digestive Diseases · doi:10.1159/000121346 · Cited by 49 · see citing works
Gastric accommodation: Physiology, diagnostic modalities, clinical relevance, and therapies
Febo‐Rodriguez, L., Chumpitazi, B. P., Sher, A. C., & Shulman, R. J. (2021) · Neurogastroenterology & Motility · doi:10.1111/nmo.14213 · Cited by 46 · see citing works
Early satiety in cancer patients: a common and important but underrecognized symptom
Davis, M. P., Walsh, D., Lagman, R. L., & Yavuzşen, T. (2006) · Supportive Care in Cancer · doi:10.1007/s00520-005-0015-4 · Cited by 45 · see citing works
Kindt, S., Dubois, D., Oudenhove, L. V., Caenepeel, P., Arts, J., Bisschops, R., & Tack, J. F. (2009) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2009.01374.x · Cited by 45 · see citing works
Maurer, A. H. (2012) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2011.10.001 · Cited by 45 · see citing works
Gwee, K., Lee, Y. Y., Suzuki, H., Ghoshal, U. C., Holtmann, G., Bai, T., Barbara, G., Chen, M., Chua, A. S. B., Gibson, P. R., et al. (2022) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16046 · Cited by 45 · see citing works
Current Medical Treatments of Dyspepsia and Irritable Bowel Syndrome
Camilleri, M., & Tack, J. F. (2010) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2010.08.005 · Cited by 44 · see citing works
Self-citationDysaccommodation of the stomach: therapeutic nirvana?
Bisschops, R., & Tack, J. F. (2006) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2006.00863.x · Cited by 43 · see citing works
Gastrointestinal complications of fundoplication
Connor, F. L. (2005) · Current Gastroenterology Reports · doi:10.1007/s11894-005-0038-5 · Cited by 43 · see citing works
Wong, G. K., Shulman, R. J., & Chumpitazi, B. P. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12499 · Cited by 42 · see citing works
Influence of acid suppressants on gastric emptying: Cross‐over analysis in healthy volunteers
Takahashi, Y., Amano, Y., Yuki, T., Ose, T., Miyake, T., Kushiyama, Y., Satō, S., Ishihara, S., & Kinoshita, Y. (2006) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2006.04270.x · Cited by 40 · see citing works
Ford, A. C., Talley, N. J., Walker, M. M., & Jones, M. (2014) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12903 · Cited by 39 · see citing works
Novel mechanisms in functional dyspepsia
Choung, R. S. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i5.673 · Cited by 39 · see citing works
Selected Interventions in Nuclear Medicine: Gastrointestinal Motor Functions
Odunsi, S. T., & Camilleri, M. (2009) · Seminars in Nuclear Medicine · doi:10.1053/j.semnuclmed.2008.11.002 · Cited by 38 · see citing works
Self-citationComparison of gastric volumes in response to isocaloric liquid and mixed meals in humans
Schepper, H. U. D., Camilleri, M., Cremonini, F., Foxx–Orenstein, A. E., & Burton, D. D. (2004) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2004.00533.x · Cited by 38 · see citing works
Self-citationGastroparesis and Dumping Syndrome: Current Concepts and Management
Vavricka, S. R., & Greuter, T. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8081127 · Cited by 37 · see citing works
van den Elzen, B. D. J., Bennink, R. J., Holman, R., Tytgat, G. N. J., & Boeckxstaens, G. E. (2007) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2007.00971.x · Cited by 37 · see citing works
Broeders, B., Carbone, F., Balsiger, L. M., Schol, J., Raymenants, K., Huang, I., Verheyden, A., Vanuytsel, T., & Tack, J. F. (2023) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17414 · Cited by 38 · see citing works
Gastric motor and sensory function
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Rosen, J. M. (2014) · World Journal of Gastrointestinal Pharmacology and Therapeutics · doi:10.4292/wjgpt.v5.i3.122 · Cited by 35 · see citing works
Gastric compliance in bulimia nervosa
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Bratten, J. R., & Jones, M. P. (2006) · Digestive Diseases · doi:10.1159/000092878 · Cited by 34 · see citing works
Effect of Vagus Nerve Integrity on Short and Long-Term Efficacy of Antireflux Surgery
van Rijn, S., Rinsma, N. F., Lindeboom, M. Y. A., Ringers, J., Gooszen, H. G., van Rijn, P. J. J., Veenendaal, R. A., Conchillo, J. M., Bouvy, N. D., & Masclee, A. (2016) · The American Journal of Gastroenterology · doi:10.1038/ajg.2016.42 · Cited by 34 · see citing works
Functional Dyspepsia: Mechanisms of Symptom Generation and Appropriate Management of Patients
Camilleri, M. (2007) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2007.07.001 · Cited by 33 · see citing works
Self-citationCamilleri, M. (2023) · Gut · doi:10.1136/gutjnl-2023-330542 · Cited by 25 · see citing works
Self-citationPharmacological agents currently in clinical trials for disorders in neurogastroenterology
Camilleri, M. (2013) · Journal of Clinical Investigation · doi:10.1172/jci70837 · Cited by 32 · see citing works
Self-citation
- Authors
- Bredenoord, A. J., Chial, H. J., Camilleri, M., Mullan, B. P., & Murray, J. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Camilleri, Michael
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2003-07
- Volume
- 1
- Issue
- 4
- Pages
- 264-272
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W2159492794
- Cited by
- 243
- References
- 44
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 13 · 2020: 12 · 2019: 15 · 2018: 11 · 2017: 7 · 2016: 9 · 2015: 10 · 2014: 8 · 2013: 11 · 2012: 10
- FWCI
- 14.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K24 DK02638, R01 DK-54681, R01 DK57982, K24DK002638, R01DK054681)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- gastric accommodation, gastric emptying, functional dyspepsia, rumination syndrome, gastric emptying scintigraphy, upper gastrointestinal symptoms
- MeSH terms
- Adolescent, Adult, Aged, Diabetes Mellitus, Dyspepsia, Fasting, Female, Gastric Emptying, Gastroesophageal Reflux, Gastrointestinal Motility, Humans, Male, Manometry, Middle Aged, Minnesota, Recurrence, Tomography, X-Ray Computed, Cohort Studies, Tomography, Emission-Computed, Single-Photon, Endoscopy, Gastrointestinal, Treatment Outcome, Ultrasonography, Interventional, Fundoplication, Postprandial Period, Upper Gastrointestinal Tract
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