Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days
CPT4 code
Name of the Procedure:
Gastric Emptying Imaging Study with Small Bowel and Colon Transit, Multiple Days
Common name: Gastric emptying scan, gastrointestinal transit study
Technical terms: Scintigraphic gastric emptying study, radionuclide transit study
Summary
A gastric emptying imaging study is a diagnostic test that uses a small amount of radioactive material to take images of how food moves through your stomach, small bowel, and colon over multiple days. It helps doctors diagnose problems with the digestive system.
Purpose
The procedure is used to identify and evaluate disorders of the gastrointestinal (GI) tract, such as gastroparesis (delayed stomach emptying), small bowel dysmotility, and colonic transit disorders. The goals include diagnosing the condition, assessing the severity, and guiding treatment plans.
Indications
- Persistent nausea and vomiting
- Bloating and fullness after meals
- Unexplained weight loss
- Chronic constipation or diarrhea
- Suspected gastroparesis or intestinal dysmotility
- Patients who do not respond to standard treatments
Preparation
- Patients are usually required to fast for 8 hours before the test.
- Certain medications that affect GI motility may need to be discontinued before the procedure, as advised by the doctor.
- Patients may be asked to avoid fiber supplements for a few days before the test.
- A preliminary assessment, including a review of medical history and symptoms, is often conducted.
Procedure Description
- Day 1: The patient consumes a meal or liquid containing a small amount of radioactive material (tracer).
- Imaging: Using a gamma camera, pictures are taken immediately after the meal and at various intervals (e.g., 0, 1, 2, 4, and sometimes 6 hours) to track how the food moves through the stomach.
- Continued Monitoring: Over the course of multiple days, further imaging is done to observe the transit of the radioactive markers through the small bowel and colon.
- Analysis: Data is collected on the rate of gastric emptying and intestinal transit, and the results are analyzed to assess motility.
Tools/equipment: Gamma camera, radioactive tracer Anesthesia/Sedation: Not required
Duration
The initial scan duration is typically about 4-6 hours on the first day, followed by shorter imaging sessions over the next 2-3 days.
Setting
The procedure is usually performed in a hospital's nuclear medicine department or an outpatient imaging center.
Personnel
- Nuclear medicine technologist
- Radiologist specializing in nuclear medicine
- Gastroenterologist (for result interpretation and management)
Risks and Complications
- Rare allergic reactions to the food or drink used in the test
- Minimal exposure to radiation, considered low risk
- Slight discomfort from fasting
Benefits
- Provides precise information about gastric and intestinal motility
- Non-invasive with minimal discomfort
- Helps in diagnosing and tailoring treatment for GI motility disorders
Recovery
- Patients can typically resume normal activities immediately after each imaging session.
- Follow-up appointments may be scheduled to discuss the results and plan further management.
- Patients should follow any specific dietary or medication instructions given by their doctor.
Alternatives
- Upper Gastrointestinal (GI) Endoscopy: Direct visualization of the GI tract but does not assess motility.
- Wireless Motility Capsule (SmartPill): Ingestible capsule that measures pH, pressure, and temperature to assess GI motility.
- Barium X-ray Study: Involves drinking a barium solution to visualize the GI tract, but provides less detailed information about motility.
Patient Experience
Patients may feel normal hunger due to fasting but typically experience minimal discomfort. During the imaging, they might need to stay still, which can be slightly uncomfortable. Post-procedure discomfort is rare, and pain management is generally not needed.