Retrospective Analysis of Gastric Emptying Scintigraphy at a Tertiary Hospital in Sub-Saharan Africa: A 10-Year Review (2013–2023)

Retrospective Analysis of Gastric Emptying Scintigraphy at a Tertiary Hospital in Sub-Saharan Africa: A 10-Year Review (2013–2023) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Retrospective Analysis of Gastric Emptying Scintigraphy at a Tertiary Hospital in Sub-Saharan Africa: A 10-Year Review (2013–2023) Christopher OPIO, Reena Shah, Annastacia Mbith, David Odada, Jasmit Shah, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5903154/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Gastric emptying scintigraphy (GES) is a vital diagnostic tool for assessing gastric motility disorders, yet data on its use and findings in sub-Saharan Africa remain scarce. Objective To characterize gastric emptying patterns and identify factors associated with delayed gastric emptying in patients undergoing GES at a tertiary hospital in sub-Saharan Africa. Methods A retrospective analysis of 138 GES records from 2013–2023 was conducted. Delayed gastric emptying was defined as gastric emptying half-time (GET1/2) cutoff > 120 minutes. Descriptive statistics and regression analyses were used to identify predictors of delayed gastric emptying. Results Of the GES procedures, 76% were performed between 2021 and 2023. Patients had a median age of 47 years (interquartile range [IQR]: 33–60), and 68.1% were women. The median GET1/2 was 150 minutes (IQR: 122–194). Diabetes mellitus, vomiting, and dopamine agonists were associated with prolonged GET1/2, while ischemic gastropathy and age 50–60 years were linked to shorter GET1/2. Delayed gastric emptying was observed in 78.3% of patients, with significant predictors including diabetes (odds ratio [OR] 8.95, 95% confidence interval [CI]: 2.28–35.19), prior gastroscopy (OR 4.04, 95% CI: 1.15–14.22), prokinetic use (OR 12.47, 95% CI: 2.10–74.03), younger age (OR 4.58, 95% CI: 1.49–14.14), and women (OR 3.65, 95% CI: 1.14–11.67). Conclusion Delayed gastric emptying is common among patients undergoing GES in this region, driven by clinical and pharmacological factors. These findings highlight the need for targeted interventions and further research on gastric motility disorders in sub-Saharan Africa. Figures Figure 1 Background One of the vital functions of the stomach is to carefully regulate the passage of gastric contents into the duodenum through the process of gastric emptying ensuring effective digestion and nutrient absorption. A disruption of gastric emptying can result in gastric emptying disorders such as gastroparesis (delayed emptying) and dumping syndrome (rapid emptying). Gastric emptying disorders usually present with persistent and troublesome upper gastrointestinal symptoms, including nausea, vomiting, dyspepsia, and early satiety. Several conditions are associated with delayed or rapid gastric emptying including diabetes mellitus, prior gastric surgery, and use of certain medications, among others [ 1 – 3 ]. Gastric emptying scintigraphy is the current gold standard for assessing and diagnosing gastric emptying disorders. It provides key diagnostic metrics like gastric emptying half-time (GET1/2) and interval residual gastric volume measurements. These measurements enable accurate diagnosis of delayed and rapid gastric emptying [ 4 , 5 ]. However, in Sub-Saharan Africa(SSA), diagnosis of gastric emptying disorders remains a challenge because of the wide differential diagnosis, and inadequate access to vital diagnostic tools including endoscopy and gastric emptying scintigraphy (GES) [ 6 , 7 ]. This increases the likelihood of misdiagnosis and is highlighted by the scarcity of published data on gastric emptying from the region [ 8 – 10 ]. Acknowledging this gap, we conducted a 10-year retrospective review of GES procedures at a tertiary center with the aim of characterizing gastric emptying patterns, identifying factors influencing GET1/2 and delayed emptying in SSA. Material and Methods This retrospective chart review utilized de-identified clinical data from the radiology department, medical records, and electronic health records database. The study included all adult records of patients who underwent GES between January 2013 and October 2023. The GES protocol at our facility involves multiple steps, which are detailed in the supplementary files. We included medical records of adult patients who underwent GES at our facility. Two trained data clerks, authorized to access, abstracted data from electronic medical records, with supplementary information manually abstracted from paper files. Key variables included socio-demographics, gastric emptying time, and relevant medical histories (e.g., past Helicobacter pylori treatment, use of antacids, surgeries, comorbidities), history of endoscopy, body mass index, and year of delayed gastric emptying diagnosis. All data was entered into Research electronic data capture (REDCap) software hosted locally, with strict access controls to ensure data security[ 11 ]. The final database, containing de-identified variables, was exported to Stata version 18 after removing medical record numbers to protect patient confidentiality. Descriptive and inferential statistic were generated using Stata version 18. Quantile statistics and quantile linear regression were used to analyze GET1/2. Gastric emptying disorders were classified into two categories: delayed (GET1/2 > 120 minutes) and rapid (GET1/2 < 30 minutes). Initial variable selection was performed using adaptive LASSO, while multiple imputation logistic regression was applied to identify factors associated with delayed gastric emptying while addressing missing data. Statistical significance was determined at a p-value threshold of < 0.05. Odds ratios (OR), regression coefficients, and 95% confidence intervals (CI) were calculated to ensure the precision of the estimates. Results We analyzed data from 138 patient records between January 2013 and October 2023. Most procedures (n = 105, 78%) were performed between 2021 and 2023. The median patient age was 47 years (IQR: 33–60 years), and women (n = 94, 68.1%) were the most frequent gender. Seventy-six patients (57%) reported bothersome upper gastrointestinal symptoms, categorized as vomiting (n = 6, 4.4%), dyspepsia (n = 47, 34%), and gastroesophageal reflux disease (GERD)-related symptoms (n = 25, 18%). Additional diagnoses included diabetes mellitus (n = 40, 29%), unspecified causes (n = 20, 14.5%), a history of Helicobacter pylori infection (n = 13, 9.4%), and medication-associated dyspepsia linked to the use of calcium channel blockers, anticholinergics, or opioids (n = 12, 8.7%). Malignancies involving the esophagus, stomach, or pancreas were reported in 9 cases (6.5%). Rare diagnoses included atherosclerosis (n = 5, 3.6%), chronic renal failure (n = 4, 2.9%), multiple sclerosis (n = 2, 1.5%), chronic pancreatitis (n = 2, 1.5%), and complications arising from surgery (n = 1, 0.7%) or radiotherapy (n = 1, 0.7%). Additionally, Parkinson’s disease was reported in a single case (0.7%). Medication histories from the year preceding GES revealed use of several medications known to influence gastric motility. These included narcotics (n = 1, 0.8%), tricyclic antidepressants (TCAs; n = 12, 8.7%), calcium channel blockers (CCBs; n = 11, 8%), clonidine (n = 2, 1.5%), dopamine agonists (n = 13, 9.4%), and GLP-1 receptor agonists (n = 12, 8.7%). Prokinetic use was documented in 35 of 112 patient records (31.3%). Of the 138 patient records, 119 (86.2%) had complete gastroscopy data prior to GES; among these, 84 (70.6%) had undergone at least one gastroscopy. These are summarized in the supplementary information files. From 138 records, the median GET1/2 was 150 minutes (IQR: 122–194). Factors influencing the median GET1/2 were investigated using quantile regression modeling assuming no prior distribution. The analysis revealed that diabetes mellitus was significantly associated with a 32.5-minute increase in gastric emptying time (95% CI: 19.9–45.1, p < 0.001), while patients aged 50–60 years experienced a 21.0-minute reduction (95% CI: -32.9 to -9.1, p = 0.0007). A history of ischemic gastropathy was associated with a 43.5-minute decrease in duration (95% CI: -71.2 to -15.8, p = 0.002). Bothersome upper gastrointestinal symptoms exhibited a gradient effect on GET1/2: vomiting was associated with a substantial increase of 148.5 minutes (95% CI: 123.6–173.4, p < 0.001), and dyspeptic symptoms increased GET1/2 by 27.0 minutes (95% CI: 14.9–39.1, p < 0.001). Gastroesophageal reflux disease symptoms, however, showed no significant association. Among medications, dopamine agonists increased GET1/2 by 35.0 minutes (95% CI: 16.1–53.9, p = 0.0004), while tricyclic antidepressants showed a trend towards increasing GET1/2 by 17.0 minutes (95% CI: -1.3 to 35.3, p = 0.068). Glucagon-like peptide-1 receptor agonists and calcium channel blockers had no significant effects on GET1/2. The model’s pseudo-R² was 0.0927. These findings are summarized in Table 1 and Fig. 1. Table 1 Factors influencing the median Gastric Emptying Half Time (minutes) Variable Coefficient 95%Confidence Interval p-value Diabetes Mellitus 32.5 (19.9, 45.1) < 0.0001 Age 50–60 years (vs. other ages) -21 (-32.9, -9.1) 0.0007 Ischemic gastropathy 43.5 (15.8, 71.2) 0.0023 Bothersome upper gastrointestinal symptoms Vomiting 148.5 (123.6, 173.4) < 0.0001 Dyspeptic symptoms 27 (14.9, 39.1) < 0.0001 GERD symptoms 1 (-13.1, 15.1) 0.8888 Medications history Dopamine Agonists 35 (16.1, 53.9) 0.0004 Tricyclic Antidepressants 17 (-1.3, 35.3) 0.068 GLP-1 Receptor Agonists (GLP) -12.5 (-34.6, 9.6) 0.2651 Calcium Channel Blockers -2 (-23.7, 19.7) 0.8554 Intercept 148 (68.7, 227.3) 0.0003 Dependent variable: Gastric Emptying Half Time-GET1/2 (minutes), Number of observations: 138, Pseudo R²: 0.0927. GERD -Gastroesophageal reflux disease, GLP-1 - Glucagon-like peptide-1 receptor agonists, vs.- versus or compared to. Figure 1. Average Marginal Effects of Various Factors on Gastric Emptying Half-Time. The figure displays the average marginal effects of different clinical and demographic factors on gastric emptying half-time (GET1/2), estimated using quantile linear regression. The dots represent the point estimates of the effects, and the horizontal lines represent the 95% confidence intervals. Positive values indicate an increase in GET1/2 (slower emptying), while negative values indicate a decrease in GET1/2 (faster emptying). Gastric Emptying Status (Rapid, Normal, and Delayed) Patient characteristics, stratified by gastric emptying status (rapid, normal, and delayed), are presented in Table 2 and as supplementary materials. Table 2 , Distribution of Patient Characteristics According to Gastric Emptying Status (Rapid, Normal, and Delayed). Characteristic Rapid (n = 2) Normal (n = 28) Delayed (n = 108) Total (n = 138) GET1/2 in minutes Median (Q1, Q3) 10.2 ( 0.33, 20) 96.4 (80.6,106.2) 166.5 (136.5, 219.5) 150 (122–194) Age in Years Median (Q1, Q3)) 47.0 (47.0,47.0) 52.0 (34.0, 52.0) 47.0 (33.0, 60.0) 47.0 (33.0, 60.0) Age < 50 years 1 (50%) 12 (42.9%) 64 (59.3%) 77 (55.8%) Age range 50–60 years 1 (50%) 12(42.9%) 19( 17.6%) 32 ( 23.2%) Woman 1 (50%) 17 (60.7%) 76 (70.4%) 94 (68.1%) Diabetes Mellitus 0 (0%) 4 (14.3%) 36 (33.3%) 40 (29.0%) Bothersome upper gastrointestinal symptoms not reported 2(100%) 15 ( 53.4%) 61 ( 56.5%) 78 (56.5%) Vomiting 0 (0%) 0 (0%) 6 (5.6%) 6 (4.4%) Dyspeptic symptoms 1(50%) 8 (28.6%) 38 (35.2%) 47 (34.1%) GERD symptoms 1(50%) 7 (26%) 17 (15.6%) 25 (18.1%) Prokinetic Use 0 (0%) 2 (8.7%) 33 (37.1%) 35 (31.2%) TCA Use 0 (0%) 4 (14.3%) 8 (7.4%) 12(8.7%) CCB 0 (0%) 1 (3.6%) 10( 9.3%) 11 (8%) GLP-1 0 (0%) 1 (3.6%) 11 (10.2%) 12 (8.7%) Gastroscopies prior to GES n = 119 (19 missing records) 0 1 (50%) 11 ( 39.4%) 23 (21.3) 35 /119 (29.4%) ≥ 1 1 (50%) 16 (57%) 67 (62%) 84/119 (70.6%) GERD -Gastroesophageal reflux disease GLP-1 - Glucagon-like peptide-1 receptor agonists CCBs- calcium channel blockers TCA - tricyclic antidepressants. Rapid emptying was diagnosed in 2(1.4%) patients, normal emptying in 28(20.3%) patients, and delayed emptying in 108 (78.3%) patients. The median GET1/2 for all the 138 patient was 150 minutes (IQR: 122–194). Within the groups, the delayed emptying group had a median GET1/2 of 166.5 minutes (IQR: 136.5–219.5), the normal group had 96.4 minutes (IQR: 80.6–106.2), and the rapid group had 10.2 minutes (IQR: 0.33–20.0). The median age across all groups was 47 years (IQR: 33–60). In the delayed emptying group, 64 (59.3%) patients were younger than 50 years, 76 (70.4%) were women, and 36 (33.3%) had diabetes mellitus. Prokinetic use was most common in the delayed group, reported in 33 patient records (37.1%) compared to 2 (8.7%) in the normal group and none in the rapid group. Similarly, the use of tricyclic antidepressants (7.4%), calcium channel blockers (9.3%), and glucagon-like peptide-1 receptor agonists (10.2%) was predominantly observed in the delayed group. Among the 119 records with available data on prior gastroscopies, 67 patient records (62%) in the delayed group had undergone at least one procedure, compared to 16 (57%) in the normal group and 1 (50%) in the rapid group. A logistic regression analysis, using multiple imputation to address missing data, identified independent predictors of delayed gastric emptying (Table 3 ). Table 3 , Factors Associated with Delayed Gastric Emptying: A Multivariable Logistic Regression Variable Odds Ratio (OR) 95% Confidence Interval (CI) p-value Number of gastroscopies prior to GES 4.04 1.15–14.22 0.03 Age less 50 years 4.58 1.49–14.14 0.008 Diabetes mellitus 8.95 2.28–35.19 0.002 Prokinetic use 12.47 2.10–74.03 0.005 identified as woman 3.65 1.14–11.67 0.029 _cons 0.04 0.01–0.22 < 0.001 Troublesome upper gastrointestinal symptoms (offset) 1 Average Relative Variance Increase after imputation = 0.095 Fraction of Missing Information addressed : 0.2342 Model F-test: (F = 4.56, p = 0.0004). The model was adjusted for troublesome upper gastrointestinal symptoms to account for the baseline risk associated with these pre-existing symptoms. The analysis revealed significant associations between delayed gastric emptying and several factors: number of prior gastroscopies, age under 50 years (compared to those 50 year and older), diabetes mellitus, prokinetic use, and being a woman (compared to being a man). Individuals with one or more prior gastroscopies had an OR of 4.04 for delayed gastric emptying (95% CI: 1.15–14.22, p = 0.030). The OR was 4.58 for those aged under 50 years (95% CI: 1.49–14.14, p = 0.008). Diabetes mellitus was associated with a substantially increased OR of 8.95 (95% CI: 2.28–35.19, p = 0.002). Prokinetic use had the strongest association, with an OR of 12.47 (95% CI: 2.10–74.03, p = 0.005). Women had an OR of 3.65 compared to men (95% CI: 1.14–11.67, p = 0.029). The constant term, representing the baseline odds of delayed gastric emptying when all other predictors are absent, had an OR of 0.04 (95% CI: 0.01–0.22, p < 0.001). Discussion This study represents, to our knowledge, the first description of gastric emptying patterns and associated factors in a tertiary hospital within SSA. Few GES procedures were performed initially, with a dramatic increase (from 33 to 105 procedures done) in the period 2021–2023, possibly reflecting a growing awareness among clinicians of the diagnostic and therapeutic value of GES for motility disorders. Most patients reported persistent upper gastrointestinal symptoms—including dyspepsia, vomiting, and GERD[ 12 ]. Common diagnoses included diabetes mellitus, idiopathic gastroparesis, and medication-related side effects. Most patients were women (median age 47 years), and a large proportion had previously undergone gastroscopy. This is consistent with what has been reported by others [ 13 – 15 ]. Quantile linear regression identified diabetes mellitus, ischemic gastropathy, vomiting, dyspepsia significantly associated with longer GET1/2. While Dopamine agonist use, TCA use, age range 50–60 years was significantly associated with shorter GET1/2. With exception of “age range 50–60 years” for which we do not have a clear explanation all other findings appear to be supported by published literature [ 12 , 16 – 21 ]. Nevertheless, a recent study did observe a "J-shaped" prevalence pattern among those with an increased GET1/2, with the lowest prevalence between 40 and 64 years[ 22 ]. Based on our facility's cutoffs, 8 out of 10 patients referred for GES were confirmed to have delayed gastric emptying. This high confirmation rate may reflect effective clinical judgment and selective referral practices. On the other hand, it could indicate that the cutoff values used in our facility are highly sensitive, favoring the diagnosis of delayed gastric emptying. We identified several factors significantly associated with delayed gastric emptying, including a history of prior gastroscopies, age < 50 years, diabetes mellitus, the use of prokinetic medications, and women. Gastroscopy performed before gastric emptying studies to rule out structural abnormalities. The finding that younger individuals (< 50 years) have increased odds of delayed gastric emptying has been reported by others [ 4 , 16 ]. The observation that women are more likely to have delayed gastric emptying has also been reported in the literature[ 14 , 23 ]. On the other hand, the strong association between use of prokinetics and delayed gastric emptying suggests that prokinetics were frequently used in this population. Prokinetic agents are commonly favored by prescribers for their perceived ability to relieve symptoms and improve gastric emptying effectively [ 15 , 24 ]. Our study has limitations. The study's relatively small sample size, reflected in the wide confidence intervals, may reduce the certainty of our findings and limit their relevance to larger or heterogeneous populations. We recognize that several potential biases could have influenced our results, including measurement bias (related to how data were collected) and referral bias (arising from how patients were selected for gastric emptying studies). To handle missing data, we used multiple imputation. We acknowledge that if the missing data were not completely random, some residual bias may exist. We used GET1/2 cutoffs than percent interval gastric residual volumes. The latter is the current recommended method for diagnosis of delayed gastric emptying due to its advantages [ 25 ]. However, one multicenter study showed that there were no significant differences between GET1/2 and percent gastric retentions at 1, 1.5, 2, 3 and 4 hours [ 26 ]. As with any observational study of this type, we cannot rule out the possibility that unmeasured factors influenced the associations we observed. Finally, the lack of external validation means that we are cautious about generalizing our findings to other populations. Despite these limitations, our study provides critical insights into gastric emptying disorders within a sub-Saharan African population. Additionally, it has catalyzed a shift in diagnostic practices at our institution, with percent interval gastric residual volumes now preferred over GET1/2 [ 27 ]. In conclusion, delayed gastric emptying was observed in 78% of patients undergoing GES at our institution, underscoring the importance of comprehensive clinical assessment and tailored therapies. These findings uncover important associations and highlight the necessity of further research to better understand gastric emptying disorders in the region. Declarations Ethics approval: this retrospective study was approved by Aga Khan ISERC-Ref:2023/ISERC-66 and NACOSTI/P/23/29070. All procedures were conducted in accordance with the ethical standards outlined in the Declaration of Helsinki and relevant institutional and national guidelines. Consent for publication: all the authors give consent for publication Competing interests: All the authors declare no competing interests Funding: This study was supported by an independent research and educational grant from Europa Healthcare Limited, Kenya. The funders had no role in the study's design, data collection, analysis, interpretation, or writing of the manuscript. Contribution of authors CKO conceptualized the study and designed the methodology. AM and DO abstracted the data, while CKO conducted the analysis and drafted the manuscript. RS, AM, DO, AS, SG, SN, KM, JS, and MDM reviewed and edited the manuscript. All authors read and approved the final version. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. References Goyal RK, Guo Y, Mashimo H. Advances in the physiology of gastric emptying. Neurogastroenterology Motil. 2019;31:e13546. Liu W, Jin Y, Wilde PJ, Hou Y, Wang Y, Han J. Mechanisms, physiology, and recent research progress of gastric emptying. Crit Rev Food Sci Nutr. 2021;61:2742–55. Staursky D, Shimoga D, Tyra A, Raguraj T, Bhardwaj V, Sharma A. S809 Gastric Emptying Scintigraphy: Understanding Nuclear Medicine’s Real World Clinical Practice. Official J Am Coll Gastroenterology| ACG. 2024;119:S556. Tougas G, Eaker EY, Abell TL, Abrahamsson H, Boivin M, Chen J, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Official J Am Coll Gastroenterology| ACG. 2000;95:1456–62. Farrell MB. Gastric emptying scintigraphy. J Nucl Med Technol. 2019;47:111–9. Grigoryan A, Bouyoucef S, Sathekge M, Vorster M, Orellana P, Estrada E et al. Development of nuclear medicine in Africa. Clin translational imaging. 2022;:1–11. Mwachiro M, Topazian HM, Kayamba V, Mulima G, Ogutu E, Erkie M, et al. Gastrointestinal endoscopy capacity in Eastern Africa. Endoscopy Int Open. 2021;9:E1827–36. Li M, Gao N, Wang S, Guo Y, Liu Z. A global bibliometric and visualized analysis of the status and trends of gastroparesis research. Eur J Med Res. 2023;28:543. Orunmuyi AT, Lawal IO, Omofuma OO, Taiwo OJ, Sathekge MM. Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research. Ecancermedicalscience. 2020;14. Cangemi DJ, Stephens L, Lacy BE. Misdiagnosis of gastroparesis is common: a retrospective review of patients referred to a tertiary gastroenterology practice. Clin Gastroenterol Hepatol. 2023;21:2670–2. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–81. Vijayvargiya P, Jameie-Oskooei S, Camilleri M, Chedid V, Erwin PJ, Murad MH. Association between delayed gastric emptying and upper gastrointestinal symptoms: a systematic review and meta-analysis. Gut. 2019;68:804–13. DiBaise J, Patel N, Noelting J, Dueck A, Roarke M, Crowell M. The relationship among gastroparetic symptoms, quality of life, and gastric emptying in patients referred for gastric emptying testing. Neurogastroenterology Motil. 2016;28:234–42. Hutson WR, Roehrkasse RL, Wald A. Influence of gender and menopause on gastric emptying and motility. Gastroenterology. 1989;96:11–7. Soykan I, Sivri B, Sarosiek I, Kiernan B, Mccallum RW, Demography. Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis. Dig Dis Sci. 1998;43:2398–404. Watson LE, Xie C, Wang X, Li Z, Phillips LK, Sun Z, et al. Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes. J Clin Endocrinol Metabolism. 2019;104:3311–9. Jalleh RJ, Jones KL, Rayner CK, Marathe CS, Wu T, Horowitz M. Normal and disordered gastric emptying in diabetes: recent insights into (patho) physiology, management and impact on glycaemic control. Diabetologia. 2022;65:1981–93. Liberski SM, Koch KL, Atnip RG, Stern RM. Ischemic gastroparesis: resolution after revascularization. Gastroenterology. 1990;99:252–7. Hiramoto B, McCarty TR, Lodhia NA, Jenkins A, Elnaiem A, Muftah M et al. Quantified Metrics of Gastric Emptying Delay by Glucagon-Like Peptide-1 Agonists: A Systematic Review and Meta-Analysis With Insights for Periprocedural Management. Official J Am Coll Gastroenterol | ACG. 2024;119. Tateno H, Sakakibara R, Shiina S, Doi H, Tateno F, Sato M, et al. Transdermal dopamine agonist ameliorates gastric emptying in Parkinson’s disease. J Am Geriatr Soc. 2015;63:2416–8. Lacy BE, Saito YA, Camilleri M, Bouras E, DiBaise JK, Herrick LM et al. Effects of Antidepressants on Gastric Function in Patients with Functional Dyspepsia. Official J Am Coll Gastroenterol | ACG. 2018;113. Huang I, Schol J, Carbone F, Chen YJ, Van den Houte K, Balsiger LM, et al. Prevalence of delayed gastric emptying in patients with gastroparesis-like symptoms. Aliment Pharmacol Ther. 2023;57:773–82. Jones KL, Russo A, Stevens JE, Wishart JM, Berry MK, Horowitz M. Predictors of delayed gastric emptying in diabetes. Diabetes Care. 2001;24:1264–9. Goelen N, Jones M, Huang I, Carbone F, Janssen P, Tack J. Do prokinetic agents provide symptom relief through acceleration of gastric emptying? An update and revision of the existing evidence. United Eur Gastroenterol J. 2023;11:146–62. Abell TL, Camilleri M, Donohoe K, Hasler WL, Lin HC, Maurer AH, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44–54. Vasavid P, Chaiwatanarat T, Pusuwan P, Sritara C, Roysri K, Namwongprom S, et al. Normal solid gastric emptying values measured by scintigraphy using Asian-style meal: a multicenter study in healthy volunteers. J Neurogastroenterol Motil. 2014;20:371. Tafti D, Farrell MB, Dearborn MC, Banks KP. Reexamining compliance with gastric emptying scintigraphy guidelines: an updated analysis of the Intersocietal Accreditation Commission Database. J Nucl Med Technol. 2024;52:26–31. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5903154","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":408147309,"identity":"5865b4a9-553d-4051-9da3-8fc57d448678","order_by":0,"name":"Christopher OPIO","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIiWNgGAWjYDACCQaGAyDaAMblZ2ADMZgJaElA0iLZQIQWBiQtQMYBAlr4Z/c+PPjzh02eOXvvA4aPOyzkjI8fS5NgqLBObMBlyZ3jBod5EtKKLXuOGzDOPCNhbHYm7ZgEw5l0nFoMJNIYDjMkHE7ccCONgZm3TSJx24H0NgnGtsN4tRz8AdJy/xlEy+b+50At//BrOcADtoUNomWDBNBhjA24tUgA3XOYJy2t2OAM0DqQXyRuPEu2SDiWboxLC/+MNOaPP2xs8gyOH2N88HFHnRx/f5rhjQ811rK4tMBAAog4wNiAzCVGCwNcyygYBaNgFIwCJAAAhPNawGTtMZwAAAAASUVORK5CYII=","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":true,"prefix":"","firstName":"Christopher","middleName":"","lastName":"OPIO","suffix":""},{"id":408147310,"identity":"e36c3a53-5e7c-44b3-bdda-e550c24d059c","order_by":1,"name":"Reena Shah","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Reena","middleName":"","lastName":"Shah","suffix":""},{"id":408147311,"identity":"ce912393-04aa-40ea-b93f-8ccc2e96ad15","order_by":2,"name":"Annastacia Mbith","email":"","orcid":"","institution":"Aga Khan University Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Annastacia","middleName":"","lastName":"Mbith","suffix":""},{"id":408147312,"identity":"0946b373-27df-4e74-bd46-4c9210e59855","order_by":3,"name":"David Odada","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Odada","suffix":""},{"id":408147313,"identity":"a26c59b5-1522-437b-ac75-e1d21c2c0543","order_by":4,"name":"Jasmit Shah","email":"","orcid":"","institution":"Aga Khan University Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Jasmit","middleName":"","lastName":"Shah","suffix":""},{"id":408147314,"identity":"977414ba-7a60-4ea6-a567-3a91ca0a5612","order_by":5,"name":"Musyoka David Mutiso","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Musyoka","middleName":"David","lastName":"Mutiso","suffix":""},{"id":408147315,"identity":"29a9c840-9b20-4b63-b42b-e2990c09659d","order_by":6,"name":"Ahmed Sokwala","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"Sokwala","suffix":""},{"id":408147316,"identity":"760cd177-8ecf-460f-8b86-f6351eb0de46","order_by":7,"name":"Samuel Nguku","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Nguku","suffix":""},{"id":408147317,"identity":"7091281c-d667-4081-aa01-2f5fee6ff5c0","order_by":8,"name":"Khalid Makhdomi","email":"","orcid":"","institution":"Aga Khan University Hospital Nairobi","correspondingAuthor":false,"prefix":"","firstName":"Khalid","middleName":"","lastName":"Makhdomi","suffix":""}],"badges":[],"createdAt":"2025-01-25 17:53:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5903154/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5903154/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75406253,"identity":"e5dc1585-200d-4bb6-b27a-ef7699efa0f9","added_by":"auto","created_at":"2025-02-04 08:51:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":30229,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAverage Marginal Effects of Various Factors on Gastric Emptying Half-Time.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe figure displays the average marginal effects of different clinical and demographic factors on gastric emptying half-time (GET1/2), estimated using quantile linear regression. The dots represent the point estimates of the effects, and the horizontal lines represent the 95% confidence intervals. Positive values indicate an increase in GET1/2 (slower emptying), while negative values indicate a decrease in GET1/2 (faster emptying).\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5903154/v1/7a4c37e4531a92437beedd60.png"},{"id":96452961,"identity":"78a60aab-c4dd-4a60-906e-047c04cab001","added_by":"auto","created_at":"2025-11-21 09:56:04","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":752305,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5903154/v1/a9fe1b21-f23f-4bae-b396-ba34f54c659e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Retrospective Analysis of Gastric Emptying Scintigraphy at a Tertiary Hospital in Sub-Saharan Africa: A 10-Year Review (2013–2023)","fulltext":[{"header":"Background","content":"\u003cp\u003eOne of the vital functions of the stomach is to carefully regulate the passage of gastric contents into the duodenum through the process of gastric emptying ensuring effective digestion and nutrient absorption. A disruption of gastric emptying can result in gastric emptying disorders such as gastroparesis (delayed emptying) and dumping syndrome (rapid emptying). Gastric emptying disorders usually present with persistent and troublesome upper gastrointestinal symptoms, including nausea, vomiting, dyspepsia, and early satiety. Several conditions are associated with delayed or rapid gastric emptying including diabetes mellitus, prior gastric surgery, and use of certain medications, among others [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGastric emptying scintigraphy is the current gold standard for assessing and diagnosing gastric emptying disorders. It provides key diagnostic metrics like gastric emptying half-time (GET1/2) and interval residual gastric volume measurements. These measurements enable accurate diagnosis of delayed and rapid gastric emptying [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, in Sub-Saharan Africa(SSA), diagnosis of gastric emptying disorders remains a challenge because of the wide differential diagnosis, and inadequate access to vital diagnostic tools including endoscopy and gastric emptying scintigraphy (GES) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. This increases the likelihood of misdiagnosis and is highlighted by the scarcity of published data on gastric emptying from the region [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Acknowledging this gap, we conducted a 10-year retrospective review of GES procedures at a tertiary center with the aim of characterizing gastric emptying patterns, identifying factors influencing GET1/2 and delayed emptying in SSA.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003eThis retrospective chart review utilized de-identified clinical data from the radiology department, medical records, and electronic health records database. The study included all adult records of patients who underwent GES between January 2013 and October 2023. The GES protocol at our facility involves multiple steps, which are detailed in the supplementary files. We included medical records of adult patients who underwent GES at our facility. Two trained data clerks, authorized to access, abstracted data from electronic medical records, with supplementary information manually abstracted from paper files. Key variables included socio-demographics, gastric emptying time, and relevant medical histories (e.g., past Helicobacter pylori treatment, use of antacids, surgeries, comorbidities), history of endoscopy, body mass index, and year of delayed gastric emptying diagnosis. All data was entered into \u003cem\u003eResearch electronic data capture (REDCap)\u003c/em\u003e software hosted locally, with strict access controls to ensure data security[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The final database, containing de-identified variables, was exported to Stata version 18 after removing medical record numbers to protect patient confidentiality. Descriptive and inferential statistic were generated using Stata version 18. Quantile statistics and quantile linear regression were used to analyze GET1/2. Gastric emptying disorders were classified into two categories: delayed (GET1/2\u0026thinsp;\u0026gt;\u0026thinsp;120 minutes) and rapid (GET1/2\u0026thinsp;\u0026lt;\u0026thinsp;30 minutes). Initial variable selection was performed using adaptive LASSO, while multiple imputation logistic regression was applied to identify factors associated with delayed gastric emptying while addressing missing data. Statistical significance was determined at a p-value threshold of \u0026lt;\u0026thinsp;0.05. Odds ratios (OR), regression coefficients, and 95% confidence intervals (CI) were calculated to ensure the precision of the estimates.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eWe analyzed data from 138 patient records between January 2013 and October 2023. Most procedures (n\u0026thinsp;=\u0026thinsp;105, 78%) were performed between 2021 and 2023. The median patient age was 47 years (IQR: 33\u0026ndash;60 years), and women (n\u0026thinsp;=\u0026thinsp;94, 68.1%) were the most frequent gender. Seventy-six patients (57%) reported bothersome upper gastrointestinal symptoms, categorized as vomiting (n\u0026thinsp;=\u0026thinsp;6, 4.4%), dyspepsia (n\u0026thinsp;=\u0026thinsp;47, 34%), and gastroesophageal reflux disease (GERD)-related symptoms (n\u0026thinsp;=\u0026thinsp;25, 18%). Additional diagnoses included diabetes mellitus (n\u0026thinsp;=\u0026thinsp;40, 29%), unspecified causes (n\u0026thinsp;=\u0026thinsp;20, 14.5%), a history of Helicobacter pylori infection (n\u0026thinsp;=\u0026thinsp;13, 9.4%), and medication-associated dyspepsia linked to the use of calcium channel blockers, anticholinergics, or opioids (n\u0026thinsp;=\u0026thinsp;12, 8.7%). Malignancies involving the esophagus, stomach, or pancreas were reported in 9 cases (6.5%). Rare diagnoses included atherosclerosis (n\u0026thinsp;=\u0026thinsp;5, 3.6%), chronic renal failure (n\u0026thinsp;=\u0026thinsp;4, 2.9%), multiple sclerosis (n\u0026thinsp;=\u0026thinsp;2, 1.5%), chronic pancreatitis (n\u0026thinsp;=\u0026thinsp;2, 1.5%), and complications arising from surgery (n\u0026thinsp;=\u0026thinsp;1, 0.7%) or radiotherapy (n\u0026thinsp;=\u0026thinsp;1, 0.7%). Additionally, Parkinson\u0026rsquo;s disease was reported in a single case (0.7%). Medication histories from the year preceding GES revealed use of several medications known to influence gastric motility. These included narcotics (n\u0026thinsp;=\u0026thinsp;1, 0.8%), tricyclic antidepressants (TCAs; n\u0026thinsp;=\u0026thinsp;12, 8.7%), calcium channel blockers (CCBs; n\u0026thinsp;=\u0026thinsp;11, 8%), clonidine (n\u0026thinsp;=\u0026thinsp;2, 1.5%), dopamine agonists (n\u0026thinsp;=\u0026thinsp;13, 9.4%), and GLP-1 receptor agonists (n\u0026thinsp;=\u0026thinsp;12, 8.7%). Prokinetic use was documented in 35 of 112 patient records (31.3%). Of the 138 patient records, 119 (86.2%) had complete gastroscopy data prior to GES; among these, 84 (70.6%) had undergone at least one gastroscopy. These are summarized in the supplementary information files.\u003c/p\u003e \u003cp\u003eFrom 138 records, the median GET1/2 was 150 minutes (IQR: 122\u0026ndash;194). Factors influencing the median GET1/2 were investigated using quantile regression modeling assuming no prior distribution. The analysis revealed that diabetes mellitus was significantly associated with a 32.5-minute increase in gastric emptying time (95% CI: 19.9\u0026ndash;45.1, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while patients aged 50\u0026ndash;60 years experienced a 21.0-minute reduction (95% CI: -32.9 to -9.1, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0007). A history of ischemic gastropathy was associated with a 43.5-minute decrease in duration (95% CI: -71.2 to -15.8, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002). Bothersome upper gastrointestinal symptoms exhibited a gradient effect on GET1/2: vomiting was associated with a substantial increase of 148.5 minutes (95% CI: 123.6\u0026ndash;173.4, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and dyspeptic symptoms increased GET1/2 by 27.0 minutes (95% CI: 14.9\u0026ndash;39.1, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Gastroesophageal reflux disease symptoms, however, showed no significant association. Among medications, dopamine agonists increased GET1/2 by 35.0 minutes (95% CI: 16.1\u0026ndash;53.9, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0004), while tricyclic antidepressants showed a trend towards increasing GET1/2 by 17.0 minutes (95% CI: -1.3 to 35.3, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.068). Glucagon-like peptide-1 receptor agonists and calcium channel blockers had no significant effects on GET1/2. The model\u0026rsquo;s pseudo-R\u0026sup2; was 0.0927. These findings are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Fig.\u0026nbsp;1.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors influencing the median Gastric Emptying Half Time (minutes)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCoefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%Confidence Interval\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(19.9, 45.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge 50\u0026ndash;60 years (vs. other ages)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-32.9, -9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIschemic gastropathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(15.8, 71.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBothersome upper gastrointestinal symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(123.6, 173.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyspeptic symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(14.9, 39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-13.1, 15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8888\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedications history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDopamine Agonists\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(16.1, 53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTricyclic Antidepressants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-1.3, 35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGLP-1 Receptor Agonists (GLP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-34.6, 9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.2651\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCalcium Channel Blockers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-23.7, 19.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.8554\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntercept\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(68.7, 227.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDependent variable: Gastric Emptying Half Time-GET1/2 (minutes), Number of observations: 138, Pseudo R\u0026sup2;: 0.0927.\u003c/p\u003e \u003cp\u003eGERD -Gastroesophageal reflux disease, GLP-1 - Glucagon-like peptide-1 receptor agonists, vs.- versus or compared to.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure 1. Average Marginal Effects of Various Factors on Gastric Emptying Half-Time.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe figure displays the average marginal effects of different clinical and demographic factors on gastric emptying half-time (GET1/2), estimated using quantile linear regression. The dots represent the point estimates of the effects, and the horizontal lines represent the 95% confidence intervals. Positive values indicate an increase in GET1/2 (slower emptying), while negative values indicate a decrease in GET1/2 (faster emptying).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eGastric Emptying Status (Rapid, Normal, and Delayed)\u003c/h3\u003e\n\u003cp\u003ePatient characteristics, stratified by gastric emptying status (rapid, normal, and delayed), are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and as supplementary materials.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e, Distribution of Patient Characteristics According to Gastric Emptying Status (Rapid, Normal, and Delayed).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRapid (n\u0026thinsp;=\u0026thinsp;2)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDelayed\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;108)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;138)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGET1/2 in minutes\u003c/p\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Q1, Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.2\u003c/p\u003e \u003cp\u003e( 0.33, 20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96.4 (80.6,106.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e166.5\u003c/p\u003e \u003cp\u003e(136.5, 219.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e150\u003c/p\u003e \u003cp\u003e(122\u0026ndash;194)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge in Years\u003c/p\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Q1, Q3))\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47.0\u003c/p\u003e \u003cp\u003e(47.0,47.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.0\u003c/p\u003e \u003cp\u003e(34.0, 52.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.0\u003c/p\u003e \u003cp\u003e(33.0, 60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.0\u003c/p\u003e \u003cp\u003e(33.0, 60.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026lt;\u0026thinsp;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64 (59.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77 (55.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge range 50\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19( 17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32 ( 23.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWoman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (60.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76 (70.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e94 (68.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (29.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBothersome upper gastrointestinal symptoms not reported\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 ( 53.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61 ( 56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78 (56.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (5.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (4.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDyspeptic symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 (35.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47 (34.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (15.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (18.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProkinetic Use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (8.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (37.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35 (31.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTCA Use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (7.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12(8.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10( 9.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGLP-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (10.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (8.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGastroscopies\u003c/p\u003e \u003cp\u003eprior to GES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;119\u003c/p\u003e \u003cp\u003e(19 missing records)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 ( 39.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35 /119 (29.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (62%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e84/119 (70.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eGERD -Gastroesophageal reflux disease\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eGLP-1 - Glucagon-like peptide-1 receptor agonists\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eCCBs- calcium channel blockers\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTCA - tricyclic antidepressants.\u003c/p\u003e \u003cp\u003eRapid emptying was diagnosed in 2(1.4%) patients, normal emptying in 28(20.3%) patients, and delayed emptying in 108 (78.3%) patients. The median GET1/2 for all the 138 patient was 150 minutes (IQR: 122\u0026ndash;194). Within the groups, the delayed emptying group had a median GET1/2 of 166.5 minutes (IQR: 136.5\u0026ndash;219.5), the normal group had 96.4 minutes (IQR: 80.6\u0026ndash;106.2), and the rapid group had 10.2 minutes (IQR: 0.33\u0026ndash;20.0). The median age across all groups was 47 years (IQR: 33\u0026ndash;60). In the delayed emptying group, 64 (59.3%) patients were younger than 50 years, 76 (70.4%) were women, and 36 (33.3%) had diabetes mellitus. Prokinetic use was most common in the delayed group, reported in 33 patient records (37.1%) compared to 2 (8.7%) in the normal group and none in the rapid group. Similarly, the use of tricyclic antidepressants (7.4%), calcium channel blockers (9.3%), and glucagon-like peptide-1 receptor agonists (10.2%) was predominantly observed in the delayed group. Among the 119 records with available data on prior gastroscopies, 67 patient records (62%) in the delayed group had undergone at least one procedure, compared to 16 (57%) in the normal group and 1 (50%) in the rapid group.\u003c/p\u003e \u003cp\u003eA logistic regression analysis, using multiple imputation to address missing data, identified independent predictors of delayed gastric emptying (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e, Factors Associated with Delayed Gastric Emptying: A Multivariable Logistic Regression\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOdds Ratio (OR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% Confidence Interval (CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of gastroscopies\u003c/p\u003e \u003cp\u003eprior to GES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.15\u0026ndash;14.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge less 50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.49\u0026ndash;14.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.28\u0026ndash;35.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProkinetic use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.10\u0026ndash;74.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eidentified as woman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.14\u0026ndash;11.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e_cons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01\u0026ndash;0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTroublesome upper gastrointestinal symptoms (offset)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eAverage Relative Variance Increase after imputation\u0026thinsp;=\u0026thinsp;0.095\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eFraction of Missing Information addressed : 0.2342\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eModel F-test: (F\u0026thinsp;=\u0026thinsp;4.56, p\u0026thinsp;=\u0026thinsp;0.0004).\u003c/p\u003e \u003cp\u003eThe model was adjusted for troublesome upper gastrointestinal symptoms to account for the baseline risk associated with these pre-existing symptoms. The analysis revealed significant associations between delayed gastric emptying and several factors: number of prior gastroscopies, age under 50 years (compared to those 50 year and older), diabetes mellitus, prokinetic use, and being a woman (compared to being a man). Individuals with one or more prior gastroscopies had an OR of 4.04 for delayed gastric emptying (95% CI: 1.15\u0026ndash;14.22, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.030). The OR was 4.58 for those aged under 50 years (95% CI: 1.49\u0026ndash;14.14, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.008). Diabetes mellitus was associated with a substantially increased OR of 8.95 (95% CI: 2.28\u0026ndash;35.19, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002). Prokinetic use had the strongest association, with an OR of 12.47 (95% CI: 2.10\u0026ndash;74.03, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005). Women had an OR of 3.65 compared to men (95% CI: 1.14\u0026ndash;11.67, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.029). The constant term, representing the baseline odds of delayed gastric emptying when all other predictors are absent, had an OR of 0.04 (95% CI: 0.01\u0026ndash;0.22, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study represents, to our knowledge, the first description of gastric emptying patterns and associated factors in a tertiary hospital within SSA. Few GES procedures were performed initially, with a dramatic increase (from 33 to 105 procedures done) in the period 2021\u0026ndash;2023, possibly reflecting a growing awareness among clinicians of the diagnostic and therapeutic value of GES for motility disorders. Most patients reported persistent upper gastrointestinal symptoms\u0026mdash;including dyspepsia, vomiting, and GERD[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Common diagnoses included diabetes mellitus, idiopathic gastroparesis, and medication-related side effects. Most patients were women (median age 47 years), and a large proportion had previously undergone gastroscopy. This is consistent with what has been reported by others [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Quantile linear regression identified diabetes mellitus, ischemic gastropathy, vomiting, dyspepsia significantly associated with longer GET1/2. While Dopamine agonist use, TCA use, age range 50\u0026ndash;60 years was significantly associated with shorter GET1/2. With exception of \u0026ldquo;age range 50\u0026ndash;60 years\u0026rdquo; for which we do not have a clear explanation all other findings appear to be supported by published literature [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17 CR18 CR19 CR20\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Nevertheless, a recent study did observe a \"J-shaped\" prevalence pattern among those with an increased GET1/2, with the lowest prevalence between 40 and 64 years[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Based on our facility's cutoffs, 8 out of 10 patients referred for GES were confirmed to have delayed gastric emptying. This high confirmation rate may reflect effective clinical judgment and selective referral practices. On the other hand, it could indicate that the cutoff values used in our facility are highly sensitive, favoring the diagnosis of delayed gastric emptying. We identified several factors significantly associated with delayed gastric emptying, including a history of prior gastroscopies, age\u0026thinsp;\u0026lt;\u0026thinsp;50 years, diabetes mellitus, the use of prokinetic medications, and women. Gastroscopy performed before gastric emptying studies to rule out structural abnormalities. The finding that younger individuals (\u0026lt;\u0026thinsp;50 years) have increased odds of delayed gastric emptying has been reported by others [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The observation that women are more likely to have delayed gastric emptying has also been reported in the literature[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. On the other hand, the strong association between use of prokinetics and delayed gastric emptying suggests that prokinetics were frequently used in this population. Prokinetic agents are commonly favored by prescribers for their perceived ability to relieve symptoms and improve gastric emptying effectively [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Our study has limitations. The study's relatively small sample size, reflected in the wide confidence intervals, may reduce the certainty of our findings and limit their relevance to larger or heterogeneous populations. We recognize that several potential biases could have influenced our results, including measurement bias (related to how data were collected) and referral bias (arising from how patients were selected for gastric emptying studies). To handle missing data, we used multiple imputation. We acknowledge that if the missing data were not completely random, some residual bias may exist. We used GET1/2 cutoffs than percent interval gastric residual volumes. The latter is the current recommended method for diagnosis of delayed gastric emptying due to its advantages [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, one multicenter study showed that there were no significant differences between GET1/2 and percent gastric retentions at 1, 1.5, 2, 3 and 4 hours [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. As with any observational study of this type, we cannot rule out the possibility that unmeasured factors influenced the associations we observed. Finally, the lack of external validation means that we are cautious about generalizing our findings to other populations. Despite these limitations, our study provides critical insights into gastric emptying disorders within a sub-Saharan African population. Additionally, it has catalyzed a shift in diagnostic practices at our institution, with percent interval gastric residual volumes now preferred over GET1/2 [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn conclusion, delayed gastric emptying was observed in 78% of patients undergoing GES at our institution, underscoring the importance of comprehensive clinical assessment and tailored therapies. These findings uncover important associations and highlight the necessity of further research to better understand gastric emptying disorders in the region.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003ethis retrospective study was\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eapproved by Aga Khan ISERC-Ref:2023/ISERC-66 and\u0026nbsp; NACOSTI/P/23/29070. All procedures were conducted in accordance with the ethical standards outlined in the Declaration of Helsinki and relevant institutional and national guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eall the authors give consent for publication\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eAll the authors declare no competing interests\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This study was supported by an independent research and educational grant from Europa Healthcare Limited, Kenya.\u003c/p\u003e\n\u003cp\u003eThe funders had no role in the study\u0026apos;s design, data collection, analysis, interpretation, or writing of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContribution of authors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCKO conceptualized the study and designed the methodology. AM and DO \u0026nbsp;abstracted \u0026nbsp;the data, while CKO conducted the analysis and drafted the manuscript. RS, AM, DO, AS, SG, SN, KM, JS, and MDM reviewed and edited the manuscript. All authors read and approved the final version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGoyal RK, Guo Y, Mashimo H. Advances in the physiology of gastric emptying. Neurogastroenterology Motil. 2019;31:e13546.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu W, Jin Y, Wilde PJ, Hou Y, Wang Y, Han J. Mechanisms, physiology, and recent research progress of gastric emptying. Crit Rev Food Sci Nutr. 2021;61:2742\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStaursky D, Shimoga D, Tyra A, Raguraj T, Bhardwaj V, Sharma A. S809 Gastric Emptying Scintigraphy: Understanding Nuclear Medicine\u0026rsquo;s Real World Clinical Practice. Official J Am Coll Gastroenterology| ACG. 2024;119:S556.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTougas G, Eaker EY, Abell TL, Abrahamsson H, Boivin M, Chen J, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Official J Am Coll Gastroenterology| ACG. 2000;95:1456\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFarrell MB. Gastric emptying scintigraphy. J Nucl Med Technol. 2019;47:111\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGrigoryan A, Bouyoucef S, Sathekge M, Vorster M, Orellana P, Estrada E et al. Development of nuclear medicine in Africa. Clin translational imaging. 2022;:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMwachiro M, Topazian HM, Kayamba V, Mulima G, Ogutu E, Erkie M, et al. Gastrointestinal endoscopy capacity in Eastern Africa. Endoscopy Int Open. 2021;9:E1827\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi M, Gao N, Wang S, Guo Y, Liu Z. A global bibliometric and visualized analysis of the status and trends of gastroparesis research. Eur J Med Res. 2023;28:543.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrunmuyi AT, Lawal IO, Omofuma OO, Taiwo OJ, Sathekge MM. Underutilisation of nuclear medicine scans at a regional hospital in Nigeria: need for implementation research. Ecancermedicalscience. 2020;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCangemi DJ, Stephens L, Lacy BE. Misdiagnosis of gastroparesis is common: a retrospective review of patients referred to a tertiary gastroenterology practice. Clin Gastroenterol Hepatol. 2023;21:2670\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)\u0026mdash;a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVijayvargiya P, Jameie-Oskooei S, Camilleri M, Chedid V, Erwin PJ, Murad MH. Association between delayed gastric emptying and upper gastrointestinal symptoms: a systematic review and meta-analysis. Gut. 2019;68:804\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDiBaise J, Patel N, Noelting J, Dueck A, Roarke M, Crowell M. The relationship among gastroparetic symptoms, quality of life, and gastric emptying in patients referred for gastric emptying testing. Neurogastroenterology Motil. 2016;28:234\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHutson WR, Roehrkasse RL, Wald A. Influence of gender and menopause on gastric emptying and motility. Gastroenterology. 1989;96:11\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSoykan I, Sivri B, Sarosiek I, Kiernan B, Mccallum RW, Demography. Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis. Dig Dis Sci. 1998;43:2398\u0026ndash;404.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWatson LE, Xie C, Wang X, Li Z, Phillips LK, Sun Z, et al. Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes. J Clin Endocrinol Metabolism. 2019;104:3311\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJalleh RJ, Jones KL, Rayner CK, Marathe CS, Wu T, Horowitz M. Normal and disordered gastric emptying in diabetes: recent insights into (patho) physiology, management and impact on glycaemic control. Diabetologia. 2022;65:1981\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiberski SM, Koch KL, Atnip RG, Stern RM. Ischemic gastroparesis: resolution after revascularization. Gastroenterology. 1990;99:252\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHiramoto B, McCarty TR, Lodhia NA, Jenkins A, Elnaiem A, Muftah M et al. Quantified Metrics of Gastric Emptying Delay by Glucagon-Like Peptide-1 Agonists: A Systematic Review and Meta-Analysis With Insights for Periprocedural Management. Official J Am Coll Gastroenterol | ACG. 2024;119.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTateno H, Sakakibara R, Shiina S, Doi H, Tateno F, Sato M, et al. Transdermal dopamine agonist ameliorates gastric emptying in Parkinson\u0026rsquo;s disease. J Am Geriatr Soc. 2015;63:2416\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLacy BE, Saito YA, Camilleri M, Bouras E, DiBaise JK, Herrick LM et al. Effects of Antidepressants on Gastric Function in Patients with Functional Dyspepsia. Official J Am Coll Gastroenterol | ACG. 2018;113.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang I, Schol J, Carbone F, Chen YJ, Van den Houte K, Balsiger LM, et al. Prevalence of delayed gastric emptying in patients with gastroparesis-like symptoms. Aliment Pharmacol Ther. 2023;57:773\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones KL, Russo A, Stevens JE, Wishart JM, Berry MK, Horowitz M. Predictors of delayed gastric emptying in diabetes. Diabetes Care. 2001;24:1264\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoelen N, Jones M, Huang I, Carbone F, Janssen P, Tack J. Do prokinetic agents provide symptom relief through acceleration of gastric emptying? An update and revision of the existing evidence. United Eur Gastroenterol J. 2023;11:146\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbell TL, Camilleri M, Donohoe K, Hasler WL, Lin HC, Maurer AH, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. J Nucl Med Technol. 2008;36:44\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVasavid P, Chaiwatanarat T, Pusuwan P, Sritara C, Roysri K, Namwongprom S, et al. Normal solid gastric emptying values measured by scintigraphy using Asian-style meal: a multicenter study in healthy volunteers. J Neurogastroenterol Motil. 2014;20:371.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTafti D, Farrell MB, Dearborn MC, Banks KP. Reexamining compliance with gastric emptying scintigraphy guidelines: an updated analysis of the Intersocietal Accreditation Commission Database. J Nucl Med Technol. 2024;52:26\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5903154/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5903154/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGastric emptying scintigraphy (GES) is a vital diagnostic tool for assessing gastric motility disorders, yet data on its use and findings in sub-Saharan Africa remain scarce.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo characterize gastric emptying patterns and identify factors associated with delayed gastric emptying in patients undergoing GES at a tertiary hospital in sub-Saharan Africa.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective analysis of 138 GES records from 2013\u0026ndash;2023 was conducted. Delayed gastric emptying was defined as gastric emptying half-time (GET1/2) cutoff\u0026thinsp;\u0026gt;\u0026thinsp;120 minutes. Descriptive statistics and regression analyses were used to identify predictors of delayed gastric emptying.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the GES procedures, 76% were performed between 2021 and 2023. Patients had a median age of 47 years (interquartile range [IQR]: 33\u0026ndash;60), and 68.1% were women. The median GET1/2 was 150 minutes (IQR: 122\u0026ndash;194). Diabetes mellitus, vomiting, and dopamine agonists were associated with prolonged GET1/2, while ischemic gastropathy and age 50\u0026ndash;60 years were linked to shorter GET1/2. Delayed gastric emptying was observed in 78.3% of patients, with significant predictors including diabetes (odds ratio [OR] 8.95, 95% confidence interval [CI]: 2.28\u0026ndash;35.19), prior gastroscopy (OR 4.04, 95% CI: 1.15\u0026ndash;14.22), prokinetic use (OR 12.47, 95% CI: 2.10\u0026ndash;74.03), younger age (OR 4.58, 95% CI: 1.49\u0026ndash;14.14), and women (OR 3.65, 95% CI: 1.14\u0026ndash;11.67).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDelayed gastric emptying is common among patients undergoing GES in this region, driven by clinical and pharmacological factors. These findings highlight the need for targeted interventions and further research on gastric motility disorders in sub-Saharan Africa.\u003c/p\u003e","manuscriptTitle":"Retrospective Analysis of Gastric Emptying Scintigraphy at a Tertiary Hospital in Sub-Saharan Africa: A 10-Year Review (2013–2023)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-04 08:51:21","doi":"10.21203/rs.3.rs-5903154/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c653b128-c0a5-4ef9-a7e3-95bdd907d036","owner":[],"postedDate":"February 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-20T10:24:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-04 08:51:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5903154","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5903154","identity":"rs-5903154","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}