13C‐gastric emptying breath tests: Clinical use in adults and children
Abstract
13 C-gastric emptying breath tests ( 13 C-GEBT) are validated, reliable, and non-invasive tools for measurement of gastric emptying (GE) velocity of solids and liquids without radiation exposure or risk of toxicity. They are recommended and routinely used for clinical purposes in adult as well as pediatric patients and can be readily performed onsite or even at the patient's home. However, the underlying methodology is rather complex and test results can be influenced by dietary factors, physical activity, concurrent diseases, and medication. Moreover, epidemiological factors can influence gastric emptying as well as production and exhalation of 13 CO 2 , which is the ultimate metabolic product measured for all 13 C-breath tests. Accordingly, in this issue of Neurogastroenterology & Motility, Kovacic et al. report performance of the 13 C-Spirulina breath test in a large group of healthy children and show significant effects of gender, pubertal status, and body size on test results. The purpose of this mini-review is to evaluate the clinical use of 13 C-GEBT in adults and children, exploring available protocols, analytical methods, and essential prerequisites for test performance, as well as the role of GE measurements in the light of the current discussion on relevance of delayed GE for symptom generation.
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The 13C breath test indirectly reflects solid meal gastric emptying, providing a radiation-free option for repeated measurements and for use in children, pregnant women, and breastfeeding women.
“It indirectly reflects solid meal gastric emptying, providing a radiation-free option for repeated measurements and for use in children, pregnant women, and breastfeeding women [67, 68].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [67]
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Eaton, S. D., Pacilli, M., Wood, J., McHoney, M., Corizia, L., Kingsley, C., Curry, J., Herod, J., Cohen, R., & Pierro, A. (2008) · UCL Discovery (University College London) · Cited by 1 · see citing works
Flagged first, then by citations
4 of the 95 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Shin, A. (2024) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(24)00231-0 · Cited by 30 · see citing works
Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment
Mandarino, F. V., Testoni, S. G. G., Barchi, A., Azzolini, F., Sinagra, E., Pepe, G., Chiti, A., & Danese, S. (2023) · Life · doi:10.3390/life13081743 · Cited by 18 · see citing works
Huang, I., Calder, S. S., Gharibans, A. A., Schamberg, G., Varghese, C., Andrews, C. N., Tack, J. F., & O’Grady, G. (2024) · Neurogastroenterology & Motility · doi:10.1111/nmo.14823 · Cited by 16 · see citing works
Prevalence and disease burden of gastroparesis in Asia
Hsu, C., Azzopardi, N., & Broad, J. (2024) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16474 · Cited by 8 · see citing works
Karrento, K., Chumpitazi, B. P., Zhang, L., Simpson, P. M., & Shulman, R. J. (2025) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003545 · Cited by 6 · see citing works
Keukelaere, M. D., Carbone, F., van Hoeve, K., Tack, J. F., & Hoffman, I. E. A. (2023) · Neurogastroenterology & Motility · doi:10.1111/nmo.14620 · Cited by 4 · see citing works
Gastroparesis for the nongastroenterologist
Araujo-Duran, J., Chatterjee, A., & Garg, S. (2024) · Cleveland Clinic journal of medicine · doi:10.3949/ccjm.91a.23078 · Cited by 3 · see citing works
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Motility Disorders of the Stomach: Pathophysiologic Mechanisms and Evaluation
Cangemi, D. J., & Lacy, B. E. (2024) · Foregut: The Journal of the American Foregut Society · doi:10.1177/26345161241239607 · Cited by 1 · see citing works
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Diabetic gastroparesis: pathophysiology and impact on insulin timing choices
Galeano, F., Tumminia, A., Oteri, V., Le Moli, R., Piticchio, T., Scilletta, S., Di Marco, M., Di Pino, A., & Frasca, F. (2026) · Endocrine · doi:10.1007/s12020-026-04693-6
Microbial metabolism of mannitol as a tracer for the non-invasive measurement of oral-cecal transitPreprint
Vieira, D. E., Langmeyer, E. M., Cortopassi, M. D., Ramachandran, D., Rubio, W. B., Kotikalapudi, N., Zhou, Y., Flier, S. N., Bry, L., & Banks, A. S. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.10.28.685202
Yin, R.-Y., Liu, Z.-J., Yao, Y.-Q., Miao, R.-Y., Guan, H.-F., Zhang, Y., Fang, X.-Y., Zhang, Y.-J., & Tian, J.-X. (2026) · World Journal of Diabetes · doi:10.4239/wjd.115749
Kodirov Sh, S., Турғунпулатовна, Д. Л., Sabirov, M., Daminova, K., Muhitdinova, N., Munnavarov, B., & Zaripov, A. (2026) · Research Square · doi:10.21203/rs.3.rs-9956373/v1
Vieira, D. E., Langmeyer, E. M., Cortopassi, M. D., Rubio, W. B., Flier, S. N., Bry, L., & Banks, A. S. (2026) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00113.2026
- Authors
- Keller, J., Hammer, H. F., & Hauser, B.
- Affiliations
- Universität Hamburg (DE)
- University of Graz (AT)
- Universitair Ziekenhuis Brussel (BE)
- Corresponding author
- Keller, Jutta
- Venue
- Neurogastroenterology & Motility
- Publisher
- Wiley
- Published
- 2021-05-17
- Volume
- 33
- Issue
- 6
- Pages
- e14172-e14172
- ISSN
- 1350-1925 (ISSN-L)
- 1365-2982
- OpenAlex
- W3161642372
- Cited by
- 15
- References
- 95
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 3
- FWCI
- 0.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurogastroenterology & Motility (publishedVersion)
- PubMed (publishedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- gastric emptying, delayed gastric emptying, pediatric patients, pubertal stage, body size, gender differences, gastroparesis, symptom generation
- MeSH terms
- Adult, Breath Tests, Carbon Isotopes, Child, Dumping Syndrome, Gastric Emptying, Humans, Gastroparesis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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