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. 2017 Nov 1;313(5):G442-G447.
doi: 10.1152/ajpgi.00190.2017. Epub 2017 Aug 3.

Relationship of gastric emptying or accommodation with satiation, satiety, and postprandial symptoms in health

Houssam Halawi  1 , Michael Camilleri  2 , Andres Acosta  1 , Maria Vazquez-Roque  1 , Ibironke Oduyebo  1 , Duane Burton  1 , Irene Busciglio  1 , Alan R Zinsmeister  3
Affiliations

Relationship of gastric emptying or accommodation with satiation, satiety, and postprandial symptoms in health

Houssam Halawi et al. Am J Physiol Gastrointest Liver Physiol. .

Abstract

The contributions of gastric emptying (GE) and gastric accommodation (GA) to satiation, satiety, and postprandial symptoms remain unclear. We aimed to evaluate the relationships between GA or GE with satiation, satiety, and postprandial symptoms in healthy overweight or obese volunteers (total n = 285, 73% women, mean BMI 33.5 kg/m2): 26 prospectively studied obese, otherwise healthy participants and 259 healthy subjects with previous similar GI testing. We assessed GE of solids, gastric volumes, calorie intake at buffet meal, and satiation by measuring volume to comfortable fullness (VTF) and maximum tolerated volume (MTV) by using Ensure nutrient drink test (30 ml/min) and symptoms 30 min after MTV. Relationships between GE or GA with satiety, satiation, and symptoms were analyzed using Spearman rank (rs ) and Pearson (R) linear correlation coefficients. We found a higher VTF during satiation test correlated with a higher calorie intake at ad libitum buffet meal (rs = 0.535, P < 0.001). There was a significant inverse correlation between gastric half-emptying time (GE T1/2) and VTF (rs = -0.317, P < 0.001) and the calorie intake at buffet meal (rs = -0.329, P < 0.001), and an inverse correlation between GE Tlag and GE25% emptied with VTF (rs = -0.273, P < 0.001 and rs = -0.248, P < 0.001, respectively). GE T1/2 was significantly associated with satiation (MTV, R = -0.234, P < 0.0001), nausea (R = 0.145, P = 0.023), pain (R = 0.149, P = 0.012), and higher aggregate symptom score (R = 0.132, P = 0.026). There was no significant correlation between GA and satiation, satiety, postprandial symptoms, or GE. We concluded that GE of solids, rather than GA, is associated with postprandial symptoms, satiation, and satiety in healthy participants.NEW & NOTEWORTHY A higher volume to comfortable fullness postprandially correlated with a higher calorie intake at ad libitum buffet meal. Gastric emptying of solids is correlated to satiation (volume to fullness and maximum tolerated volume) and satiety (the calorie intake at buffet meal) and symptoms of nausea, pain, and aggregate symptom score after a fully satiating meal. There was no significant correlation between gastric accommodation and either satiation or satiety indices, postprandial symptoms, or gastric emptying.

Keywords: fullness bloating; nausea; nutrient; pain.

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Figures

Fig. 1.
Fig. 1.
Relationship between satiation (volume to comfortable fullness) during Ensure nutrient drink test and satiety at a buffet meal test.
Fig. 2.
Fig. 2.
Relationship of gastric emptying (scintigraphy) with satiation (Ensure nutrient drink test) and with satiety (buffet meal kcal intake) measurements; note lower kcal intake with both Ensure nutrient drink ingested at 30 ml/min and ad libitum buffet meal with slower gastric emptying.
Fig. 3.
Fig. 3.
Relationship of gastric emptying (scintigraphy) and postprandial symptoms: note the increase in aggregate as well as pain and nausea scores with slower gastric emptying (GE).
Fig. 4.
Fig. 4.
Absence of significant correlation between gastric emptying T1/2 by scintigraphy and gastric accommodation measured as the difference between postprandial and fasting gastric volume measured by SPECT.
See this image and copyright information in PMC

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